How to use the different types of inhalers for Asthma

If you have been diagnosed with Asthma by your doctor, it is likely that you have been prescribed an inhaler to help manage your symptoms. Using your inhaler correctly is important to ensure you get the right amount of medicine deposited into your lungs. Incorrect use of your inhaler may mean the medication is not getting to your lungs and instead is ending up at the back of your throat or mouth and preventing you from getting the correct dose. This can make managing your Asthma difficult as the doctor will think the inhaler is not working when in fact you are just not getting the full benefit from it.

A recent survey carried out by Asthma UK showed that up to a third of Asthma patients were not using their inhalers properly.

Since inhaler technique is so important for good Asthma control, we have provided instructions for use of most common types of inhalers. Please read our information carefully, along with the manufacturer’s information leaflet to help you better use your Asthma inhaler device.

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Metered dose “MDI” or Press and Breath Inhalers

These are perhaps the most common inhalers and often the first choice of inhaler when someone is diagnosed with Asthma. Examples of an MDI inhaler are Ventolin or Clenil inhalers. These inhalers are very simple to use for many people but they do rely on a degree of hand and eye coordination by the user and it is common for people to struggle with this. Follow the instructions below to get the best out of this type of inhaler

How to use your Metered-Dose Inhaler (MDI)

To open the inhaler, remove the mouthpiece cover-check there is no object in the mouthpiece.
Hold the inhaler upright with your thumb on the base and your finger on the top of the canister and shake the inhaler up and down 4 or 5 times.
Breathe out as far as is comfortable, away from the MDI. Do not breathe out into the inhaler.
Put the mouthpiece to your lips. Seal your lips around the mouthpiece.
Start to breathe in slowly and gently. As you begin to breathe in, press the top of the canister down fully to release one dose. Continue breathing in slowly and steadily and as deeply as you can until your lungs are full.
Remove the device from your mouth and hold your breath for 5 to 10 seconds and then breathe out slowly. You can now continue to breathe normally.
For a second dose, wait around 30 seconds and then repeat steps 2 – 6.
To close, replace the mouthpiece cover.

Breathe Actuated MDI Inhalers

This type of inhaler is similar to the standard MDI inhaler above but is instead of pressing to release the dose of medication, you simple breath in and the dose releases in response to your breath. These inhalers are generally used for patients who struggle to coordinate the press and breathe method.

There a few different types of Breath Actuated Inhalers and the instructions differ slightly with these. We have listed the most common examples of prescribed inhaler:

How to use your breath actuated Autohaler®device

Hold the Autohaler® upright. Remove the mouthpiece cover by pulling down on the lip at the back.
Shake the Autohaler®. Push the lever on the top of the device up so that it stays up. Make sure your hand is not blocking the air vent on the bottom of the device.
Breathe out as far as is comfortable, away from the Autohaler®. DO not breathe out into the device.
Put the mouthpiece in your mouth and close your lips around it.
Breathe in slowly and steadily through the mouthpiece. Continue to breathe in when you hear the device “clicking”-this is the dose being released.
Remove the Autohaler® and hold your breathe for 5-10 seconds and then breathe out slowly.
Push the lever on top of the device down (off position).
For a second dose, wait 30 seconds and repeat steps 2-7. 9. Replace the mouth piece cover

How to use your Easi-Breathe® device

Hold the Easi-Breathe® inhaler upright. Do not cover the air holes at the top of the device with your fingers. Shake the inhaler up and down 3 to 5 times.
Open the cap covering the mouthpiece. The inhaler is now ready and the dose is activated.
Breathe out as far as is comfortable, away from the Easi-breathe®. Do not breathe out into the device.
Put the mouthpiece to your lips. Seal your lips around the mouthpiece.
Breathe in slowly and steadily until your lungs are full. Continue to breathe in after the dose is released.
Remove the device and hold your breath for 5 to 10 seconds and then breathe out slowly. Breathe normally.
Close the mouthpiece cover.
For a second dose, wait 30 seconds and repeat steps 1 – 7.
When finished, replace the mouthpiece cover.

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Dry powder (Breath in hard) inhalers

These inhalers have a similar method to the breath-actuated inhalers above but the particles are very fine and so you have to breathe hard and fast to get them down into your lungs. There are a few examples of these including Turbohalers, Accuhalers (such as Seretide Accuhalers), Diskhalers, and Easyhalers.

How to use your Turbohaler

To open the Turbohaler®, unscrew and lift off the mouthpiece cover.
Hold the Turbohaler® upright with the coloured grip at the bottom.
Twist the grip as far as it can go one way and then twist it back again until you hear a click. The dose is now ready.
Breathe out as far as is comfortable, away from the Turbohaler®.
Put the mouthpiece to your lips. Seal your lips around the mouthpiece. Breathe in as strongly and deeply as you can until your lungs are full.
Remove the device and hold your breath for 5 to 10 seconds and then breathe out slowly. Breathe normally.
For a second dose, wait 30 seconds and repeat steps 2 – 6.
Replace mouthpiece cover.

How to use your EasyHaler

To open the Easyhaler®, hold the inhaler device in one hand and remove the mouthpiece cover with the other hand. Shake the device up and down 3 to 5 times.
Hold the device upright with your thumb on the base and forefinger on the top of the inhaler. Press down once on the coloured button with your forefinger until you hear a click. Release your forefinger. The dose is now ready.
Breathe out as far as is comfortable, away from the Easyhaler®.
Put the mouthpiece in your mouth. Seal your lips around the mouthpiece. Breathe in steadily as strongly and deeply as you can until your lungs are full.
Remove the device and hold your breath for 5 to 10 seconds and then breathe out slowly. Breathe normally.
For a second dose, wait 30 seconds and repeat steps 2 – 5.
Replace the mouthpiece cover after use.

How to use your Accuhaler

To open the Accuhaler®, hold the outer case in one hand and put the thumb of your other hand on the thumb grip. Push the thumb grip away until you hear a click, this reveals the mouthpiece.
Hold the Accuhaler® with the mouthpiece towards you. Slide the lever beside the mouthpiece away from you until it clicks. The dose is now ready.
Breathe out as far as is comfortable, away from the Accuhaler®.
Put the mouthpiece to your lips. Breathe in steadily as strongly and deeply as you can until your lungs are full.
Remove the device and hold your breath for 5 to 10 seconds and then breathe out slowly. Breathe normally.
To close, slide the thumb grip back towards you, covering the mouthpiece and lever until it clicks shut.
For a second dose, wait 30 seconds and repeat steps 1-6.

How to use your Breezhaler

Remove the mouthpiece cover. Hold the base of the inhaler firmly and tilt the mouthpiece backward to open the capsule chamber.
Immediately before use, with dry hands, remove one capsule only from the blister. Place the capsule into the capsule chamber and close the mouthpiece until you hear a ‘click’.
Hold the inhaler upright with the mouthpiece pointing up. Pierce the capsule by firmly pressing together both side buttons at the same time. Do this only once. You should hear a ‘click’ as the capsule is being pierced. Release the side buttons fully.
Breathe out as far as is possible, away from the inhaler.
Place the mouthpiece in your mouth and close your lips firmly around the mouthpiece.
Breathe in as strongly and deeply as you can. You will hear a whirring noise as you breathe in.
Take the inhaler from your mouth and hold your breath for 5 to 10 seconds and then breathe out slowly. Breathe normally.
Open the inhaler to see if any powder is left in the capsule. If there is powder left in the capsule, close the inhaler and repeat steps 4-7.
Open the mouthpiece again, remove the empty capsule by tipping it out of the capsule chamber. Put the empty capsule in your household waste. Close the inhaler and replace the mouthpiece cover.

How to use your NEXThaler

To open, hold the NEXThaler® in the upright position and open the mouthpiece cover fully.
Breathe out as far as is comfortable, away from the NEXThaler® device.
Put the mouthpiece to your mouth and close your lips around the mouthpiece. Do not cover the air vents.
Breathe in through your mouth as strongly and deeply as you can until your lungs are full.
Remove the NEXThaler® from your mouth and hold your breath for 5 to 10 seconds and then breathe out slowly. Breathe normally.
Close the mouthpiece fully.
For a second dose, wait 30 seconds and repeat steps 1-6.

How to use your Spiromax

To open the inhaler, fold the wine red mouthpiece cover down until one loud click is heard. The inhaler is now ready for use.
Breathe out gently (as far as is comfortable), away from the Spiromax® device.
Put the mouthpiece between your teeth and close your lips around the mouthpiece. Do not cover the air vents.
Breathe in through your mouth as strongly and deeply as you can until your lungs are full. You may notice a taste when you take your dose.
Remove the inhaler from your mouth and hold your breath for 5 to 10 seconds and then breathe out slowly. Breathe normally.
Fold the red mouthpiece cover up to cover the mouthpiece.
For a second dose, wait 30 seconds and repeat steps 1-6.

Further information and guidance including videos demonstrating the various inhalers can be found at https://www.asthma.org.uk/advice/inhalers-medicines-treatments/using-inhalers/.