How to Use an Asthma Inhaler Correctly: A Step-by-Step Guide

How Asthma Inhalers Work

Asthma inhalers allow you to breathe medication directly into your lungs — precisely where it’s needed. This direct delivery is far more efficient than tablets or syrups, which must pass through the digestive system and bloodstream before reaching the airways. A Ventolin (salbutamol) blue inhaler begins working within 3–5 minutes of inhalation.

However, this precision only works if the medication actually reaches the lungs. Research consistently shows that a significant proportion of asthma patients use their inhaler incorrectly — with estimates ranging from 70% to 90% making at least one technique error. Poor technique means medication is deposited in the throat instead, and the treatment simply doesn’t work as it should.

Types of Asthma Inhaler

The most common reliever in the UK is the Ventolin Evohaler (salbutamol 100mcg) — a pressurised MDI. The Salamol Inhaler is bioequivalent and follows the same technique.

How to Use a Pressurised MDI — Step by Step

The pressurised metered dose inhaler (pMDI) is the most widely prescribed inhaler device in the UK. Follow these steps every time:

1. 1

   Remove cap & shake

   Remove the mouthpiece cap and shake the inhaler vigorously for 3–5 seconds. If it’s new or unused for 5+ days, release 2 test puffs into the air first to prime it.

2. 2

   Hold upright & breathe out fully

   Hold the inhaler upright with your thumb on the base. Breathe out gently and fully — but comfortably, not forced. Do not breathe out into the mouthpiece.

3. 3

   Seal lips around mouthpiece

   Place the mouthpiece between your teeth and form a tight seal with your lips. Do not cover the small air holes with your fingers. Do not bite down.

4. 4

   Begin inhaling slowly — then press simultaneously

   This is the most critical step. Start breathing in slowly and deeply, then simultaneously press firmly on the canister. The press and the inhale should happen together. Continue your slow, deep inhalation.

5. 5

   Hold breath for 10 seconds

   Remove the inhaler from your mouth. Hold your breath for 10 seconds (or as long as comfortable). This allows medication particles to settle deep in the lungs.

6. 6

   Exhale slowly

   Breathe out gently through your mouth. Avoid a sharp forceful exhale which can dislodge settled medication.

7. 7

   Wait 30 seconds for second puff

   If a second puff is required, keep the inhaler upright, wait 30 seconds, shake again, and repeat from step 2.

8. 8

   Replace the cap

   Replace the mouthpiece cap to keep the inhaler clean between uses.

The Most Common Inhaler Mistakes

How to Use a Spacer Device

A spacer attaches to your pMDI, creating a holding chamber. Press the canister once into the spacer, then inhale the medication at your own pace — removing the need for perfect coordination. Clinical studies show spacers can increase lung medication delivery by up to 50%.

1. 1

   Attach inhaler to spacer

   Remove the cap, shake the inhaler, and push the mouthpiece firmly into the back end of the spacer.

2. 2

   Breathe out gently

   Exhale fully away from the spacer mouthpiece.

3. 3

   Seal lips around spacer mouthpiece

   Form a tight seal. For young children, use a face mask attachment instead.

4. 4

   Press canister once

   Press firmly down on the inhaler canister to release one puff into the spacer chamber.

5. 5

   Inhale slowly & deeply

   Breathe in through the spacer slowly and as deeply as you can. The medication stays suspended briefly so there is no rush.

6. 6

   Hold breath 10 seconds — exhale slowly

   Hold your breath as before, then breathe out gently. For a second puff, wait 30 seconds and repeat from step 2.

Using a Preventer Inhaler: Key Additional Points

• Use every day as prescribed — including days when you feel completely well
• The protective effect takes 1–2 weeks to fully build — don’t stop if you feel better immediately
• Always rinse your mouth with water and spit after using a steroid preventer inhaler — this significantly reduces the risk of oral thrush
• If using both a reliever and a preventer, use the reliever first, wait a few minutes, then use the preventer

How to Clean Your Inhaler

• Remove the metal canister from the plastic body — do not wash the canister itself or place it in water
• Rinse the plastic body and mouthpiece cap under warm running water
• Shake out excess water and leave all parts to air dry thoroughly — at least an hour, ideally overnight
• Reassemble only once fully dry
• Never use hot water, detergent, or dishwashers

Inhaler Technique for Children

• Children under 5 should always use a spacer with a face mask attachment
• Children aged 5–7 may be able to use a spacer with a mouthpiece — encourage 3–5 slow breaths per puff
• Older children and teenagers can usually manage a standard MDI with a spacer
• Always demonstrate the technique yourself and watch them use it — poor technique in children often goes undetected
• Ask your GP or pharmacist for an annual inhaler technique check

When to Replace Your Inhaler

• Monitor the dose counter on your Ventolin Evohaler and reorder well before it reaches zero
• Check the expiry date — expired inhalers may deliver inconsistent doses
• Replace if dropped or visibly damaged
• If unused for 5+ days, re-prime with 2 test puffs
• Never let your inhaler run out without a replacement ready