Open a PDF version to print this topic

HealthInfo 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 can't seal their lips around the mouthpiece – usually up to two to three years of age.

Ways of using a spacer

There are two ways of using a spacer:

Multiple-breath method

This is best in an asthma emergency and for small children.

  1. Shake the inhaler vigorously to mix the medication and propellant.
  2. Insert the inhaler into the spacer.
  3. Position the mouthpiece in your mouth and ensure a good seal.
  4. Press once for one puff.
  5. For children, allow about six normal breaths through the spacer, checking that the valve is moving. Adults should only need three to four breaths.
  6. Remove the inhaler from the spacer.
  7. Repeat the above steps if you need further doses.


Deep-breath method

This is the recommended method, except for small children or if you're very breathless.

  1. Shake the inhaler vigorously to mix the medication and propellant.
  2. Insert the inhaler into the spacer.
  3. Position the mouthpiece in your mouth and ensure a good seal.
  4. Breathe out gently.
  5. Give one puff of the medication into the spacer.
  6. Take a long, slow, deep breath in and hold your breath for at least five seconds or as long as is comfortable.
  7. Breathe out.
  8. Repeat if you need more puffs of medication.

Care of your spacer

Wash a new spacer before use and then every week.

  1. Remove the base from the spacer.
  2. Wash it in warm water with detergent in a clean bowl.
  3. Remove the spacer from the water and allow it to drip dry.
  4. 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 doesn't get blocked, otherwise you won't get the full dose of medication. You should clean your inhaler every week.

  1. Remove the metal canister from the plastic inhaler. It's important that the metal canister doesn't get wet.
  2. Rinse the cap and the mouthpiece of the plastic inhaler under warm water for 30 seconds.
  3. Shake off the excess water and dry thoroughly with a paper towel.
  4. 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 aren't sure, spray a puff of medication into the air. You'll be able to see the spray coming out of the inhaler and hear a whooshing noise. If there's no spray or noise, the inhaler is probably empty.

If you haven't used your inhaler for a while

If you haven't used your inhaler for a week or more, spray a puff 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 six 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

  HealthInfo recommends the following pages

Written by Child Health, Christchurch Hospital, Canterbury DHB. Adapted by HealthInfo clinical advisers. Last reviewed June 2021. Last updated December 2021.

Page reference: 20758

Review key: HIASA-39947