A metered dose inhaler is a small aerosol can in a plastic holder that gives a burst of medicine straight to the lungs.

Adding a spacer makes it easier to use and makes sure the right amount of medicine gets into the lungs. The spacer holds the medicine released from the inhaler, to give more time to inhale into the lungs. Using a spacer may lessen side effects.


Getting Inhaler and Spacer Ready

Prime the inhaler by shaking it for 5 seconds. Then spray 4 puffs into the air away from you. The inhaler should be primed before the first use and if it has not been used in 2 weeks.


How to Use the Inhaler and Spacer

  1. Remove the mouthpiece caps from the spacer and the inhaler.

  2. Put the inhaler mouthpiece into the larger end of the spacer.

  3. Shake the inhaler and spacer well to mix the medicine.

  4. Sit upright, tilt head back slightly and breathe out to empty the lungs of air.

  5. Put the spacer mouthpiece in the mouth and seal the lips around it.

  6. Squeeze the inhaler once to release one puff.

  7. Breathe in slowly and deeply through the mouth over 3-5 seconds. If you are not able to take a single deep breath, take 3 or 4 slow deep breaths.

  8. Hold your breath for 10 seconds or for as long as you can. This allows the medicine to reach all the areas of the lungs.

  9. Remove the spacer from the mouth and breathe out.

  10. Resume normal breathing.

  11. Shake inhaler well between puffs.

  12. Repeat steps 3 through 11 for more puffs.

If using a steroid inhaler, rinse your mouth or brush your teeth after each use.

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How to Use a Spacer and Mask with a Child’s Metered Dose Inhaler

  1. Remove the mouthpiece caps from the spacer and the inhaler.

  2. Put the inhaler mouthpiece into the larger end of the spacer.

  3. Shake the inhaler and spacer well to mix the medicine.

  4. Sit the child upright and provide support with the child’s chin tilted up slightly.

  5. Gently place the mask over the child’s mouth and nose. Squeeze the inhaler once to release a puff of medicine into the spacer.

  6. Keep holding the mask over the child’s mouth and nose for 5-6 breaths. The flap valve inside the spacer should open slightly with each breath.

  7. Remove the mask from the child’s face.

  8. Shake inhaler well between puffs.

  9. Repeat steps 3 through 7 for more puffs.

If giving a child a steroid inhaler using the spacer with mask, wipe their face with warm water and dry their face. Have the child rinse their mouth if they can, to avoid thrush.

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Metered Dose Inhaler Facts

Store the inhaler at room temperature. Avoid storing in a car, as extreme hot and cold can affect the medicine.

Check the expiration date on the inhaler. Each inhaler has a certain number of puffs or “actuations.” If the inhaler does not have a counter on it, figure out how many puffs are used a day. Mark it on a calendar so you know when to start a new inhaler.

Be sure to refill the inhaler prescription well before the inhaler is empty, when the counter reaches zero.


Cleaning the Inhaler and Spacer

  • Wash the spacer with dish soap and warm water weekly. Rinse with warm water and air dry on a clean towel.

  • Do not scrub the inside of the spacer; it has a special coating inside.

  • Do not put the inhaler in water.

  • Once a week, use a dry cotton swab to clean the opening where the puff sprays out of the inhaler.