With so many different inhalers on the market today, many patients wonder if they’re using their inhaler correctly. There are 2 main categories of inhalers available: metered-dose inhalers (MDI) and dry powder inhalers (DPI). MDIs release a fixed dose of an aerosol form of the medication. HFA aerosols and Respimats® are the 2 major types of MDIs. DPIs rely on patients inhaling a powder form of the medication for a chamber, rather than an aerosol that is pushed out of the inhaler.
Different inhalers involve different techniques when using them. It’s important to make sure you’re using the correct technique in order to receive the maximum benefit from your medication.
Some types of medication, even when available in different inhalers, require the same special considerations. All inhaled steroids, such as fluticasone and budesonide, require that you rinse your mouth with water after each use. It’s important to make sure you rinse and spit out the water, and don’t swallow it.
While it’s extremely important to always refer to the medication guide for proper instructions, here is an overview of how to use some of the common inhalers that many people use.
Using Metered-Dose Inhalers:
When using an HFA inhaler, it is important to ‘prime’ it before its first use. In order to do this, after removing the mouth cap, shake the inhaler and then press down on the canister. Repeat this 3 times. Now your inhaler is read to use! Before each use, ensure that the canister is secure in the actuator and that there are no foreign materials in the inhaler. When ready to use your inhaler, exhale and secure your mouth around the mouthpiece. Press down on the canister while inhaling. Once inhaled, hold your breath as long as you can, up to 10 seconds. Remove the inhaler then exhale. Your HFA inhaler is good until the date on the packaging.
To use your Respimat®, remove the clear base of the inhaler by pressing the safety catch. Insert the narrow end of the cartridge press it down firmly on a sturdy, flat surface until it clicks. Put the clear base back on then twist in the direction of the arrows. Open the mouthcap and aim the inhaler towards the ground. Prime it by pressing the dose release button. If you see a mist, the device is primed. When ready to use the inhaler, ensure that the cap is open and twist the clear cover in the direction of the arrows. Completely exhale and secure your mouth around the mouthpiece. Press the dose release button and inhale. Hold your breath for as long as you can up to 10 seconds. Your Respimat® inhaler is good for 3 months after you remove it from its packaging.
Using Dry Powder Inhalers:
When using your Diskus inhaler, grasp the inhaler in your left hand and place your right hand in the thumb grip. Slide the thumb grip away from you until it clicks. Hold the inhaler flat with the mouthpiece towards you and slide the lever away from the mouthpiece until it clicks. Once the inhaler is in the open position, do not close it until you use your dose. Exhale, and then secure your mouth around the mouthpiece. When ready, quickly and deeply inhale and hold your breath for as long as you can up to 10 seconds. Exhale slowly and close the inhaler. Rinse your mouth out with water after every use. Your Diskus inhaler is good for 1 month after removing it from its foil pouch.
To use your Ellipta® inhaler, slide the cover until it clicks. Exhale fully. Secure your mouth over the mouthpiece and hold the inhaler flat. Make sure that your fingers aren’t covering the air vent. Inhale quickly and deeply and hold your breath for 4 seconds. Make sure you rinse your mouth out with water after each use. Your inhaler is good for 6 weeks after opening it.
If you are unsure which inhaler you have, refer to your inhaler’s medication guide for more information. Examples of medications that come in MDIs include albuterol sulfate HFA (ProAir® HFA, Ventolin® HFA, Proventil® HFA), budesonide/formoterol (Symbicort®), ipratropium/albuterol (Combivent® Respimat®), and fluticasone (Flovent® HFA). The 3 types of DPIs are Turbuhaler®/Flexhaler®, Accuhaler/Diskus, and Ellipta®. Examples of medications that come in DPIs include fluticasone furoate (Arnuity® Ellipta®), fluticasone/vilanterol (Breo® Ellipta®), fluticasone/salmeterol (Advair Diskus), budesonide (Pulmicort Flexhaler®), and albuterol sulfate (ProAir® Respiclick®).
Understanding how to properly use your inhaler can be overwhelming. If you don’t see your inhalers mentioned here, or if you have any more questions about your inhaler, stop by Precision Pharmacy where one of our pharmacists will be happy to assist you! This content was originally provided by Andrew P. Waibel, Pharm.D. Candidate 2020