HealthInfo Waitaha Canterbury
Using a spacer
Using a spacer with your metered dose inhaler (MDI, inhaler or puffer) can reduce side effects, especially from steroid inhalers. Using a spacer can also make the medicine you breathe in up to 50% more effective by helping to get the correct dose into your lungs.
Adults and older children can place the mouthpiece of the spacer directly into their mouth. The mask in the picture below is only for children who cannot seal their lips around the mouthpiece – usually up to 2 to 3 years of age.
Ways of using a spacer
There are 2 ways of using a spacer:
Multiple-breath method
This is best in an asthma emergency and for small children.
- Shake the inhaler vigorously to mix the medication and propellant.
- Insert the inhaler into the spacer.
- Position the mouthpiece in your mouth and ensure a good seal.
- Press the inhaler once for 1 dose.
- For children, allow about 6 normal breaths through the spacer, checking that the valve is moving. Adults should only need 3 to 4 breaths.
- Remove the inhaler from the spacer.
- Repeat the above steps if you need further doses.
Deep-breath method
This is the recommended method, except for small children or if you are very breathless.
- Shake the inhaler vigorously to mix the medication and propellant.
- Insert the inhaler into the spacer.
- Position the mouthpiece in your mouth and ensure a good seal.
- Breathe out gently.
- Press the inhaler once for 1 dose.
- Take a long, slow, deep breath in and hold your breath for at least 5 seconds or as long as is comfortable.
- Breathe out.
- Repeat if you need more doses of medication.
Care of your spacer
Wash a new spacer before use and then every week.
- Remove the base from the spacer.
- Wash it in warm water with detergent in a clean bowl.
- Remove the spacer from the water and allow it to drip dry.
- Replace the base when the spacer is dry.
Care of your inhaler
Clean your inhaler regularly so that the hole at the bottom where the medication comes out does not get blocked, otherwise you will not get the full dose of medication. You should clean your inhaler every week.
- Remove the metal canister from the plastic inhaler. It is important that the metal canister does not get wet.
- Rinse the cap and the mouthpiece of the plastic inhaler under warm water for 30 seconds.
- Shake off the excess water and dry thoroughly with a paper towel.
- When completely dry, replace the metal canister and mouthpiece cap.
Intal Forte or Tilade are sticky and block the inhaler easily, so you should clean them every day. They usually come with a spare plastic case so you can use one while cleaning and drying the other.
Never wash inhalers containing inhaled steroid medications. Wipe them with a dry tissue.
Checking if your inhaler is empty
When you shake your inhaler, you should be able to feel or perhaps hear the medication inside. If you are not sure, spray a dose of medication into the air. You will be able to see the spray coming out of the inhaler and hear a whooshing noise. If there is no spray or noise, the inhaler is probably empty.
If you have not used your inhaler for a while
If you have not used your inhaler for a week or more, spray a dose into the air before using it. This will make sure that your inhaler will work properly.
Extra tips
Make sure you have a spacer available for home and work or school.
Replace your spacer with a new one after 6 months of regular use or 12 months of intermittent use. You can get a new spacer from your doctor or pharmacy.
HealthInfo recommends the following videos
- National Asthma Council of Australia – How to use a Standard MDI (puffer) and Spacer
A video showing how to use a spacer.
HealthInfo recommends the following pages
- Matatiki Child and Youth Health, Canterbury DHB – About your child's spacer
Information about spacers for children, including how to use and care for them.
Written by Child Health, Christchurch Hospital, Canterbury DHB. Adapted by HealthInfo clinical advisers. Last reviewed June 2021. Last updated December 2021.
Review key: HIASA-39947
