Why Technique Matters

Studies show that over 70% of inhaler users have poor technique. Poor technique means less medication reaches the lungs and more is deposited in the mouth and throat, reducing effectiveness. Correct technique makes a significant difference to symptom control.

How to Use a Metered Dose Inhaler (MDI/Puffer)

  1. 1

    Shake the inhaler for 5 seconds

    Remove the cap. Shake the inhaler vigorously for 5 seconds. If using a new inhaler or one that has not been used for more than 3 days, prime it by pressing the canister twice into the air (away from your face).

  2. 2

    Breathe out fully

    Breathe out as much air as you comfortably can before placing the inhaler in your mouth. This creates maximum space in the lungs for medication.

  3. 3

    Seal lips around the mouthpiece

    Place the mouthpiece in your mouth between your teeth and seal your lips around it. Your tongue should be flat underneath the mouthpiece — not blocking the opening.

  4. 4

    Press and breathe in slowly simultaneously

    This is the most critical and most commonly mishandled step. Press down on the canister and at the exact same moment begin breathing in slowly and deeply. Breathing in too fast (a common error) deposits most medication in the throat. Slow, steady inhalation over 3–5 seconds maximises lung delivery.

  5. 5

    Hold your breath for 10 seconds

    Remove the inhaler from your mouth. Hold your breath for 10 seconds (or as long as comfortable). This allows the medication to settle deep in the lungs before breathing out. Breathe out slowly through your nose or mouth away from the inhaler.

  6. 6

    If a second dose is needed, wait 1 minute

    For a second puff, wait 1 minute after the first before repeating. Replace the cap after use.

Using a Spacer (Strongly Recommended)

A spacer is a plastic chamber that attaches to the inhaler. It holds the medication cloud so you do not need to perfectly coordinate pressing and breathing. Spacers significantly increase the amount of medication reaching the lungs compared to inhaler alone — especially important for children, older people, and anyone who finds coordination difficult. Your GP can prescribe one or they are available at pharmacies.

See your doctor or pharmacistHave your technique checked by a doctor, nurse or pharmacist at least annually. Poor technique is very common and is one of the most addressable causes of poorly controlled asthma. Always follow the specific instructions for your particular inhaler — some types (dry powder, soft mist) have different techniques.

Frequently Asked Questions

Most modern inhalers have a dose counter that decrements with each use. Check it regularly. For older inhalers without counters: do not use the float test (floating an inhaler in water can damage it). Instead, count doses or note the date you started. Order a replacement when the counter shows 20–30 doses remaining so you are not caught without medication.
Reliever inhalers (usually blue, e.g. Ventolin/salbutamol) work within minutes to open constricted airways during symptoms. Use when needed. Preventer inhalers (usually brown, orange, red or purple, e.g. Flixotide, Pulmicort, Seretide) contain steroids that reduce airway inflammation over time. Use daily as prescribed even when well — preventers work slowly and will not help during an acute attack.