Using a Metered-Dose Inhaler with a Spacer

To control asthma, you need to use your medicines the right way. Some medicines are inhaled using a device called a metered-dose inhaler (MDI). MDIs deliver medicine with a fine spray. Your healthcare provider has prescribed a special chamber or spacer to use with your inhaler. A spacer increases the amount of medicine that goes to your lungs by preventing it from landing on your tongue or the back of your mouth. This reduces the irritation to your throat. It helps increase the amount of medicine that makes it to your lungs. It may make your medicine work better.

Steps for using an inhaler with a spacer

Step 1:

  • Wash your hands.

  • Check the expiration date and the counter of the inhaler, if present.

  • Remove the cap from the inhaler.

  • Shake the inhaler well. If the inhaler is being used for the first time or has not been used for a while, prime it as directed by the product maker. Make sure to prime the inhaler in the air away from your face.

  • Check to make sure the metal canister is put correctly into the plastic boot, or holder, of the inhaler. See the package insert for instructions.

  • Attach the spacer to the inhaler. Then remove the cap from the spacer mouthpiece.

Step 2:

  • Breathe out normally, away from the spacer.

  • Put the mouthpiece of the spacer past your teeth and above your tongue. Close your lips tightly around it.

  • Keep your chin up or level.

Step 3:

  • Press down on the canister 1 time to release the medicine

  • Then breathe in through your mouth as slowly and deeply as you can. This should take about 5 to 10 seconds. If you breathe too quickly, you may hear a whistling sound in certain spacers.

Step 4:

  • Take the spacer mouthpiece out of your mouth. Close your lips.

  • Hold your breath up to 10 seconds if you are able.

  • Slowly breathe out through your mouth.

  • After using your inhaler, rinse your mouth with water by swishing, gargling, and spitting out the water. Never swallow it. Inhaled corticosteroids can cause a fungal infection called thrush in your mouth and throat.

  • Wash your hands again when you are done.

Six steps in using metered-dose inhaler with a spacer.


If you’re prescribed more than 1 puff of medicine at a time, wait up to 60 seconds, or as directed by your healthcare provider, between puffs. This number may be different for different medicines. Shake the inhaler again. Then repeat steps 2 to 4.

You can find important information about the medicine in the package insert. This is the paper that comes with the medicine.

If you use more than one inhaler, ask your healthcare provider which one to use first.

Your healthcare provider or pharmacist can show you how to use your inhaler and spacer the right way.

Know how many puffs are left in your inhaler. That way you won't run out of your medicine when you need it. Ask your provider how to know how many puffs are left.

Keeping your inhaler and spacer clean will help to keep your inhaler working correctly. Read the package insert for care and cleaning instructions.

Online Medical Reviewer: Chris Southard RN
Online Medical Reviewer: Jessica Gotwals RN BSN MPH
Online Medical Reviewer: Marianne Fraser MSN RN
Date Last Reviewed: 7/1/2023
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