How to Use an Asthma Inhaler Correctly: A Step-by-Step Guide
Step-by-step technique for aerosol inhalers, spacers, dry powder inhalers such as the Turbohaler, and breath-actuated inhalers such as the Autohaler, plus the common mistakes and how to look after your inhaler.
Part of our asthma guide: symptoms, triggers and treatment.
Asthma attack? Get help now. Call 999 if your reliever isn’t helping, you’re too breathless to speak, eat or sleep, your breathing is getting faster, or your lips or fingertips are turning blue or grey. While you wait, sit up straight and take 1 puff of your blue reliever every 30 to 60 seconds, up to 10 puffs, through a spacer if you have one. If the ambulance hasn’t arrived after 10 minutes, repeat. Don’t fill in an online consultation in an emergency.
The short version: most of us get at least one thing wrong with an inhaler, and that means less medicine reaches the lungs. With an aerosol inhaler (pMDI), breathe in slowly and press as you start to breathe in, ideally through a spacer. With a dry powder inhaler (DPI), breathe in fast and deep. Either way, hold your breath for up to 10 seconds afterwards. And do ask a pharmacist or asthma nurse to watch you use it at every review — they’ll spot the little things you won’t.
Already have a prescription? You can see all our asthma inhalers online.
Order Your Usual Asthma Inhaler
Access Doctor is a GPhC-registered pharmacy (#9011198). If you’re an adult with diagnosed asthma or COPD, a pharmacist independent prescriber reviews your online consultation and supplies your usual inhaler if it’s safe, and we let your GP know. Approved before 3pm, Monday to Friday? Dispatched the same day, by Royal Mail Tracked 48, Tracked 24 or Special Delivery guaranteed by 1pm next working day: you choose. Delivery is free on orders over £40.
Start Asthma Consultation →Who our online service is for. Access Doctor supplies asthma and COPD inhalers to adults aged 18 and over who already have a diagnosis, for the same inhaler, strength and dose they’re prescribed now, and we share the consultation with your GP. We can’t diagnose asthma or start or change treatment online. Children’s inhalers are managed by their GP or asthma nurse.
Why Inhaler Technique Matters
A lot of how well your inhaler works comes down to how you use it. If the technique is off, less medicine reaches your lungs — and your asthma can look badly controlled when the real problem is simply the way the inhaler is being used. Studies of people with asthma and COPD have linked these common “critical” errors to more symptoms and more flare-ups.
The right technique depends on the device. An aerosol inhaler (pMDI, the classic “spray” inhaler) needs a slow, steady breath. A dry powder inhaler (DPI) needs a fast, deep breath. Use the wrong technique for your device and it won’t work nearly as well.
Get your technique checked regularly. UK guidance (NICE NG245) says it should be checked at every asthma review, whenever your asthma gets worse, and before any change of treatment. Even people who’ve used an inhaler for years can drift into bad habits — it’s very common.
Prefer to watch? Asthma + Lung UK has short videos for each type of inhaler, including aerosols with a spacer, the Turbohaler, Accuhaler, Ellipta and Respimat.
Which Type of Inhaler Do You Have?
| Device | How to recognise it | Examples | Breath |
|---|---|---|---|
| Aerosol (pMDI) | A metal canister you press down in a plastic holder | Ventolin Evohaler, Salamol, Clenil Modulite, Serevent, Atrovent | Slow and steady; use a spacer |
| Dry powder (DPI) | No canister; you load a dose by twisting, clicking or opening | Symbicort, Pulmicort and Bricanyl Turbohalers, Seretide Accuhaler | Fast and deep |
| Breath-actuated aerosol | An aerosol that fires by itself when you breathe in; has a lever or a cap that primes it | Qvar Autohaler, Easi-Breathe inhalers | Slow and deep; no spacer |
| Soft mist (SMI) | A twist-and-press device that releases a slow mist | Spiriva Respimat | Slow and deep |
How to Use a pMDI Inhaler (Step-by-Step)
A pressurised metered-dose inhaler (pMDI) is the classic aerosol inhaler — the one used for Ventolin Evohaler, Clenil Modulite, Fostair and plenty of others. The steps are simple enough, but the timing takes a little practice:
1
Remove the cap and shake
Take off the mouthpiece cover and give the inhaler a good shake. If it’s new, or you haven’t used it in a while, test-spray it into the air, away from your face, as the leaflet describes.
2
Breathe out gently
Breathe out slowly and comfortably, away from the mouthpiece. Don’t breathe out into it.
3
Position and seal
Hold the inhaler upright, with your finger on top of the canister and your thumb under the mouthpiece. Put the mouthpiece in your mouth between your teeth and close your lips around it. Keep your chin up slightly.
4
Start to breathe in slowly, then press
Start breathing in slowly and steadily through your mouth, and as you do, press the canister down once. Keep breathing in slowly and deeply for 3 to 5 seconds. This is the fiddly bit. The most common mistake is pressing before you’ve actually started breathing in.
5
Hold your breath
Take the inhaler out of your mouth and hold your breath for up to 10 seconds, or as long as is comfortable. That pause is what lets the medicine settle in your lungs.
6
Breathe out slowly
Breathe out gently, away from the mouthpiece.
7
Wait before a second puff
Need another puff? Wait about 30 seconds, shake the inhaler again and repeat from step 2. Pop the cap back on afterwards to keep dust out.
Tip: if you see a mist escaping from the top of the inhaler or the corners of your mouth, the timing or seal wasn’t quite right. Don’t worry — that’s exactly what spacers are for. They take the timing problem out of the equation completely.
How to Use a pMDI with a Spacer
A spacer, such as the AeroChamber Plus, is simply a plastic chamber that holds the spray while you breathe it in. It takes the timing pressure off, gets more medicine into your lungs and leaves less in your mouth. Most people using an aerosol inhaler are better off with one, and it’s especially useful with steroid inhalers and during an asthma attack.
1
Shake the inhaler and fit it to the spacer
Take the cap off the inhaler, shake it, and push its mouthpiece into the back of the spacer. Check the valve in the spacer mouthpiece moves freely.
2
Breathe out gently
Breathe out slowly, away from the spacer.
3
Seal your lips around the spacer mouthpiece
Put the mouthpiece between your teeth and close your lips around it.
4
Press the inhaler once
Press the canister once to release one puff into the spacer. Don’t press again until you’ve breathed that one in.
5
Breathe in
Either breathe in slowly and deeply and hold your breath for up to 10 seconds, or take 4 or 5 normal breaths in and out through the spacer. If the spacer whistles, you’re breathing in too fast.
6
Wait before the next puff
For a second puff, wait about 30 seconds, shake the inhaler again (it can stay in the spacer) and repeat from step 3.
How to Use a DPI Inhaler
Dry powder inhalers (DPIs) work differently from aerosols. You’ll see them in several shapes — the Turbohaler, Accuhaler, Ellipta and Nexthaler — but the principle is the same for all of them. The one big difference: breathe in fast and deep, not slowly.
1
Load the dose
Load the dose as the leaflet shows: slide the lever on an Accuhaler, twist and click a Turbohaler, or open the cover on an Ellipta. Most dry powder inhalers aren’t shaken; check your leaflet.
2
Breathe out away from the device
Breathe out as far as is comfortable, but never into the mouthpiece: moisture from your breath makes the powder clump together.
3
Seal and breathe in fast and deep
Put the mouthpiece in your mouth, seal your lips, and breathe in as fast and as deeply as you can in one smooth breath. That fast airflow is what lifts the powder into your lungs.
4
Hold your breath
Take the device out of your mouth and hold your breath for up to 10 seconds, then breathe out slowly, away from the mouthpiece.
5
Close and store
Close the device as the leaflet shows and keep it somewhere dry — not the bathroom.
Dry powder inhalers may not work well in a severe attack, when you may not be able to breathe in hard enough. If you’re very breathless and use a blue aerosol reliever, use it with a spacer. If your reliever is a dry powder inhaler (such as Symbicort used as AIR or MART, or Bricanyl), follow your action plan and call 999 if it isn’t helping.
How to Use a Turbohaler
The Turbohaler is the device behind Symbicort, Pulmicort and Bricanyl:
1
Unscrew the cover and hold it upright
Hold the Turbohaler upright with the coloured grip at the bottom. Before first use, prime it as the leaflet describes.
2
Twist and click
Twist the grip as far as it goes one way, then back the other way until you hear a click. That click is one dose loaded.
3
Breathe out, then breathe in fast
Breathe out away from the mouthpiece. Put the mouthpiece between your teeth, close your lips around it, and breathe in as quickly and deeply as you can.
4
Hold your breath and replace the cover
Hold your breath for up to 10 seconds, breathe out away from the device, and screw the cover back on. You may not taste or feel the dose — that’s completely normal, so don’t take another puff thinking it didn’t work.
How to Use a Breath-Actuated Inhaler
Breath-actuated aerosol inhalers, such as the Qvar Autohaler and Easi-Breathe inhalers, fire automatically when you breathe in. No timing a press — which is why they suit people who find a standard aerosol hard to coordinate.
- Prime it: for an Autohaler, push the lever up until it stays up; for an Easi-Breathe, shake it and open the cap.
- Breathe out gently, away from the mouthpiece.
- Seal your lips around the mouthpiece, keeping your hand away from the air vents.
- Breathe in slowly and deeply. Don’t stop when you hear the click; keep breathing in.
- Hold your breath for up to 10 seconds, then breathe out slowly.
- Reset it: push the Autohaler lever down, or close the Easi-Breathe cap, before the next puff.
Breath-actuated inhalers can’t be used with a spacer. Prime and clean them exactly as the leaflet says; the Qvar Autohaler, for example, shouldn’t be put in water.
Common Inhaler Technique Mistakes
| Mistake | Device | What to do instead |
|---|---|---|
| Pressing the canister before starting to breathe in | pMDI | Start breathing in first, then press as you keep breathing in |
| Breathing in too fast (the spacer whistles) | pMDI, spacer | Breathe in slowly and steadily over 3 to 5 seconds |
| Breathing in too slowly | DPI | Breathe in as fast and as deep as you can in one breath |
| Breathing out into the mouthpiece | All | Always breathe out away from the device first |
| Pressing 2 or more puffs into a spacer at once | pMDI with spacer | One puff at a time |
| Not holding your breath afterwards | All | Hold for up to 10 seconds after each dose |
| Not shaking an aerosol | pMDI | Shake well before each puff |
| Stopping when you hear the click | Breath-actuated | Keep breathing in after the click |
| Keeping a dry powder inhaler somewhere damp | DPI | Keep it dry; never in the bathroom |
| Not rinsing after a steroid inhaler | Preventers and combination inhalers | Rinse your mouth and spit after each dose |
When to Use Your Reliever Inhaler
A blue reliever inhaler (salbutamol, such as Ventolin or Salamol, or terbutaline, such as Bricanyl) is used:
- when you have asthma symptoms: wheezing, breathlessness, chest tightness or cough
- before exercise, if your GP or asthma nurse has advised it
- in an asthma attack: 1 puff every 30 to 60 seconds, up to 10 puffs, through a spacer if you have one, while you wait for help
If your reliever is a combination inhaler used as AIR or MART, follow your asthma action plan instead. In an attack this is usually 1 puff every 1 to 3 minutes, up to 6 puffs; call 999 if you’re not better or feel worse at any point. On a normal day, most people need no more than 8 puffs of Symbicort in total, up to 12 for a short time, and needing that many means your asthma needs a review. Needing a blue reliever more than twice a week (apart from before exercise) means your asthma isn’t controlled: see your GP or asthma nurse about your preventer. UK guidance says no one with asthma should rely on a blue reliever alone. Our guide to what Ventolin is used for covers doses and side effects.
If your reliever isn’t working, or you need it more often than every 4 hours, get urgent medical help. Call 999 if you’re very breathless or can’t speak in full sentences. See our asthma attack guide.
Cleaning and Maintaining Your Inhaler
A dirty or blocked inhaler gives you less medicine, so it’s worth a minute of housekeeping now and then. Always follow your leaflet, but in general:
- Aerosol (pMDI): clean the plastic holder about once a week. Take the canister out, rinse the holder under warm running water, and let it dry completely before putting the canister back. Never put the metal canister in water.
- Spacer: wash about once a month in warm soapy water and let it air-dry; don’t rub it dry, which creates static. Replace it about every 12 months, or sooner if it’s cracked.
- Dry powder (DPI): wipe the mouthpiece with a clean, dry cloth or tissue. Never use water.
- Breath-actuated: wipe the mouthpiece with a dry tissue; don’t take it apart or put it in water.
- Know when it’s empty: replace an inhaler when its dose counter reaches zero, even if it still seems to spray. Some aerosols, including the Ventolin Evohaler, have no counter, so keep a note of your puffs.
- Disposal: return used and unwanted inhalers to a pharmacy rather than putting them in household waste, and don’t puncture or burn aerosol canisters. Aerosol inhalers have a much bigger carbon footprint than dry powder ones; our asthma inhalers guide explains lower-carbon options to discuss at your review.
Reliever · Rx
Ventolin Evohaler 100mcg
Salbutamol aerosol, the blue inhaler. 200 puffs. From £8.99.
View product →Reliever · Rx
Salamol 100mcg
The same medicine, salbutamol, in a different inhaler. From £13.99.
View product →Device
AeroChamber Plus adult spacer
Helps more of each puff reach your lungs. £9.99.
View product →Combination · Rx
Symbicort Turbohaler
Steroid and fast-acting reliever in one; used daily, or as AIR or MART. From £41.99.
View product →Safety, your GP and free NHS options
Asthma inhalers are prescription-only medicines in the UK. Before anything is supplied, a GPhC-registered pharmacist independent prescriber reviews your consultation, including the other medicines you take — some, such as beta-blockers, can make asthma worse.
- Relievers on their own: since 2024, UK guidance (NICE, BTS and SIGN) says adults with asthma shouldn’t be treated with a reliever alone, and in April 2025 the MHRA reminded prescribers not to supply one without an inhaled steroid. If you don’t use a preventer, we can supply a reliever once and will ask you to see your GP or asthma nurse.
- How many: up to 2 reliever inhalers per order. If you’ve needed 3 or more in the last 12 months, we’ll ask you to have an asthma review first; needing that many is linked to a higher risk of severe attacks.
- Read the leaflet in the pack, and ask a pharmacist or asthma nurse to check your technique.
- Report side effects to a pharmacist or doctor. You can also report them to the MHRA through the Yellow Card scheme.
We share your consultation with your GP because asthma needs ongoing care. Access Doctor is a private service, and there are free NHS options too:
- Your GP practice: asthma reviews (at least once a year) and repeat prescriptions; many practices let you order repeats through the NHS App.
- Prescription charges: NHS prescriptions are free in Scotland, Wales and Northern Ireland. In England a charge applies unless you’re exempt, and a prepayment certificate can save money if you need several items.
- Urgent advice: NHS 111 (NHS 24 on 111 in Scotland), or 999 in an emergency.
Need Your Usual Inhaler?
Access Doctor is a GPhC-registered pharmacy (#9011198). If you’re an adult with diagnosed asthma or COPD, a pharmacist independent prescriber reviews your online consultation and supplies your usual inhaler if it’s safe, and we let your GP know. Approved before 3pm, Monday to Friday? Dispatched the same day, by Royal Mail Tracked 48, Tracked 24 or Special Delivery guaranteed by 1pm next working day: you choose. Delivery is free on orders over £40.
Start Asthma Consultation →Frequently Asked Questions
How do you use a pMDI inhaler correctly?
Take the cap off and shake the inhaler. Breathe out gently, away from the mouthpiece. Put the mouthpiece in your mouth and seal your lips around it. Start to breathe in slowly, then press the canister once while you keep breathing in slowly for 3 to 5 seconds. Take the inhaler out, hold your breath for up to 10 seconds, then breathe out slowly. Wait about 30 seconds before a second puff. Using a spacer makes this much easier and is recommended for most people.
What are the most common inhaler technique mistakes?
The most common are pressing the canister before starting to breathe in, breathing in too fast with an aerosol inhaler, breathing in too slowly with a dry powder inhaler, breathing out into the mouthpiece, pressing more than one puff into a spacer at once, not shaking an aerosol inhaler, and not holding your breath afterwards. Most people make at least one mistake, so ask a pharmacist or asthma nurse to check your technique at every review.
How do I use an inhaler with a spacer?
Shake the inhaler and fit it into the spacer. Breathe out gently, away from the spacer. Seal your lips around the spacer mouthpiece and press the canister once. Either breathe in slowly and deeply and hold your breath for up to 10 seconds, or take 4 or 5 normal breaths in and out through the spacer. Wait about 30 seconds and shake again before the next puff. Only press one puff into the spacer at a time.
How do I use a DPI inhaler?
Load the dose as your device’s leaflet describes. Breathe out away from the mouthpiece. Put the mouthpiece in your mouth, seal your lips and breathe in as fast and as deeply as you can in one smooth breath. Hold your breath for up to 10 seconds, then breathe out slowly, away from the device. Never breathe out into a dry powder inhaler, and keep it dry. Dry powder technique (fast) is the opposite of aerosol technique (slow).
How do I use a Turbohaler?
Unscrew the cover and hold the Turbohaler upright, grip at the bottom. Twist the grip as far as it goes one way, then back until it clicks. Breathe out away from the mouthpiece, seal your lips around it, and breathe in as quickly and deeply as you can. Hold your breath for up to 10 seconds, then put the cover back on. You may not taste anything; that’s normal. Symbicort, Pulmicort and Bricanyl all use the Turbohaler.
How do I use an Autohaler or Easi-Breathe inhaler?
These breath-actuated inhalers fire automatically as you breathe in, so there’s no press to time. For an Autohaler, push the lever up; for an Easi-Breathe, shake it and open the cap. Breathe out away from the mouthpiece, seal your lips, and breathe in slowly and deeply; keep going when you hear the click. Hold your breath for up to 10 seconds, then reset the device (lever down, or close the cap). They aren’t used with a spacer.
Should I rinse my mouth after using an inhaler?
After a steroid inhaler (a preventer or a combination inhaler), yes: rinse your mouth with water, or brush your teeth, and spit it out. This lowers the risk of oral thrush and a hoarse voice. It isn’t needed after a blue reliever on its own.
How do I know when my inhaler is empty?
Many inhalers, including most dry powder inhalers, have a dose counter or indicator; replace the inhaler when it reaches zero or turns red, even if it still seems to work. Some aerosol inhalers, including the Ventolin Evohaler, have no counter, so keep a note of your puffs and replace it before the stated number is used. Shaking it or floating the canister in water isn’t a reliable check.
For symptoms, triggers and how asthma is diagnosed, see our asthma guide.
References
- NICE, BTS and SIGN. Asthma: diagnosis, monitoring and chronic asthma management (NG245), November 2024. nice.org.uk
- Usmani OS et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respiratory Research, 2018.
- Lavorini F et al. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Respiratory Medicine, 2008.
- Electronic Medicines Compendium. Ventolin Evohaler 100 micrograms: Summary of Product Characteristics. medicines.org.uk
- NHS. Asthma: treatment (including how to use your inhaler). nhs.uk
- MHRA Drug Safety Update. Short-acting beta-2 agonists (SABA): reminder of the risks from overuse in asthma and changes in the SABA prescribing guidelines, April 2025. gov.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.