Asthma Treatment Tips for Using Metered-Dose Inhalers By Pat Bass, MD Pat Bass, MD LinkedIn Twitter Dr. Bass is a board-certified internist, pediatrician, and a Fellow of the American Academy of Pediatrics and the American College of Physicians. Learn about our editorial process Updated on December 28, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by John Carew, MD Medically reviewed by John Carew, MD LinkedIn Twitter John Carew, MD, is board-certified in otolaryngology-head and neck surgery. He is an adjunct assistant professor at Mount Sinai Medical Center and NYU Medical Center. Learn about our Medical Review Board Fact checked Verywell Health content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Nick Blackmer Fact checked by Nick Blackmer LinkedIn Nick Blackmer is a librarian, fact-checker, and researcher with more than 20 years’ experience in consumer-oriented health and wellness content. Learn about our editorial process Print Metered-dose inhalers (MDIs) are some of the most prescribed asthma inhalers today. Here are a few tips that will help you get the most out of your MDI. There are now many different types of inhalers for asthma such as dry powder inhalers and breath-actuated inhalers. Make sure that the instructions you are following are for your type of inhaler. Because your asthma control is dependent on getting medication into your lungs, your inhaler technique is very important. While your healthcare provider is one source of education for inhaler technique, there are other options. Your pharmacy might be able to give you instructions. You might also ask your healthcare provider about referring you to an asthma educator who can review your technique and provide feedback. 1 Practice, Practice, Practice! BSIP / UIG / Getty Images One thing that should help you master the technique of using a metered-dose inhaler is to watch yourself follow the steps in front of a mirror. You can also ask your healthcare provider, respiratory therapist, or office nurse to watch you use your MDI. Do not practice with a real prescribed medicine because you could inadvertently exceed your prescribed daily dose and experience adverse side effects. Ask your healthcare provider for an MDI that does not contain active medication. This “placebo” MDI can be safely used to practice MDI technique. 2 Prime New or Infrequently Used Inhalers If your metered-dose inhaler is brand new, or if you haven’t used it for a while, you may need to “prime” it before use. The specific instructions vary, and the length of time since the last use may be a few days or a few weeks. In general, you’ll need to shake the MDI, then hold it away from your mouth and spray it one or more times into the open air. You may need to shake the inhaler before each spray. Familiarize yourself with the directions that came with your inhaler. Priming will help make sure you get the full dose once you get ready to use the inhaler. 3 Don't Skip the Exhale Step An important step in using your MDI is to blow out all the air in your lungs that you can before you breathe in the puff of medicine. Exhaling not only helps you take a deeper breath, but it also helps you get the medicine deeper into your airways. 4 Wait 1 Whole Minute Before a Second Puff If two puffs are prescribed at a time for either your controller medicine or your rescue inhaler, be sure to wait a full minute after the first puff before you take the second puff. This will ensure that the first puff has been fully circulated throughout your airways. 5 Prevent Fungal Growth If you use an inhaled steroid medicine in your MDI, you could have some fungal growth in your mouth from leftover medicine after your puffs. To prevent this, rinse your mouth well with water after each dose. Spit out the water; don’t swallow it. Also, using your MDI just before brushing your teeth is a good way to avoid three things: fungal colonization, a bad taste in your mouth, and a hoarse voice. 6 Watch the Heat Never store your MDI in a place where it may be subject to high temperatures. This includes car trunks and glove boxes, or anywhere in the direct sunlight. Kitchens and bathrooms are better avoided, as well. 7 Know the Difference Between an MDI and a DPI Metered-dose inhalers are not the same as dry powder inhalers (DPIs), and using them is different, too. Make sure you know what you have. Examples of DPIs are: Advair Diskus Asmanex Twisthaler Foradil Aerolizer Pulmicort Flexihaler Serevent Diskus You don’t need to shake a DPI and you should never blow into the inhaler. 8 Take Good Care of Your Inhaler It’s important to keep your asthma inhaler clean so that it will keep working properly. When it’s not kept clean, it may clog, preventing you from getting the full dose of your medicine in a puff. For many inhalers, you should rinse the actuator (but not the canister that contains the medication) under warm, running water for at least 30 seconds, at least once a week. Let it air dry. Note that some other inhalers should not be cleaned with water, so be sure to follow the directions that came with your inhaler. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 1 Source Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Heart, Lung, and Blood Institute. How to use a metered-dose inhaler.