Asthma and COPD Inhalers: How to Use Them Right for Better Breathing

Most people with asthma or COPD rely on inhalers to breathe easier. But here’s the hard truth: if you’re not using your inhaler right, you’re wasting most of your medicine. Studies show 70 to 90% of patients mess up their technique. That means instead of getting 40-60% of the drug into your lungs, you’re lucky to get 8-30%. The rest? It’s stuck in your mouth, throat, or on the floor. And that’s not just a waste-it’s dangerous. Your symptoms don’t improve. You end up in the ER more often. You might even need stronger meds because the simple ones aren’t working.

Why Technique Matters More Than the Device

It’s easy to think the brand of your inhaler makes the difference. ProAir? Ventolin? Diskus? Ellipta? They all have different names, shapes, and prices. But here’s what the experts agree on: how you use it matters more than what you use. A 2023 review by the Agency for Healthcare Research and Quality found that when used correctly, all inhalers perform equally well. The real gap? Technique. Poor use cuts effectiveness by 30-40%. That’s like taking half a pill and thinking you got the full dose.

Dr. Robert Openbush from the American Lung Association puts it plainly: “Proper technique is the single most important factor in inhaler effectiveness, more critical than the specific device chosen.”

The Three Main Types of Inhalers (And How They Work)

There are three kinds of inhalers you’re likely to be prescribed. Each works differently-and each needs a different technique.

• Metered-Dose Inhalers (MDIs): These are the classic aerosol cans you shake and spray. They deliver a puff of medicine using a propellant. Common brands include ProAir HFA and Ventolin HFA. You press the canister and breathe in at the same time. Sounds simple? Most people get it wrong.
• Dry Powder Inhalers (DPIs): These don’t use propellant. Instead, you breathe in fast and hard to pull the powder into your lungs. Examples: Diskus, Ellipta, Turbuhaler. No shaking. No timing. Just a strong, quick breath.
• Soft Mist Inhalers: These are newer. Respimat is the main one. It releases a slow, fine mist over 1.5 seconds. You don’t need to time your breath as tightly, but you still need to inhale deeply.

Here’s the catch: Not every inhaler works for every person. If you have severe COPD and can’t take a deep, fast breath, a DPI might not work for you. If you’re shaky or have arthritis, pressing an MDI might be hard. Your doctor should match the device to your ability-not just your diagnosis.

How to Use an MDI Correctly (7 Steps)

If you’re using a metered-dose inhaler, here’s the exact way to do it. Do this every time. No shortcuts.

1. Remove the cap and shake the inhaler well for 5 seconds.
2. Hold the inhaler upright, with the mouthpiece at the bottom.
3. Breathe out fully-away from the inhaler. Don’t blow into it.
4. Place the mouthpiece in your mouth and seal your lips around it.
5. Start breathing in slowly through your mouth. As you begin to inhale, press down on the canister to release the puff.
6. Keep breathing in slowly for 3-5 seconds until your lungs are full.
7. Hold your breath for 10 seconds. This lets the medicine settle into your airways.
8. Breathe out slowly through your nose.

Wait 60 seconds before taking another puff. If you need a second dose, repeat the whole process. Skipping the wait means you’re just spraying more medicine into your throat, not your lungs.

How to Use a Dry Powder Inhaler Correctly

DPIs don’t need timing. But they need power.

1. Load the dose according to the device’s instructions (some twist, some slide, some click).
2. Hold the inhaler away from your mouth and breathe out fully.
3. Place the mouthpiece in your mouth and seal your lips tightly.
4. Breathe in quickly and deeply-like you’re trying to suck a thick milkshake through a straw.
5. Hold your breath for 10 seconds.
6. Breathe out slowly.

Don’t breathe into the device before inhaling-that blows the powder out. And never open the capsule or try to pour the powder out. DPIs are designed to be used as-is. Breaking the seal ruins the dose.

Spacers: The Secret Weapon for MDIs

If you’re using an MDI, get a spacer. It’s a plastic tube that attaches to the inhaler. It holds the puff of medicine so you don’t have to time your breath perfectly.

Here’s why it’s a game-changer:

• Increases lung delivery by 70-100%
• Reduces throat irritation and oral thrush
• Makes it easier for kids, seniors, and anyone with coordination issues

Use it like this: Attach the spacer to your MDI. Shake well. Breathe out. Press the inhaler once. Then breathe in slowly through the spacer for 3-5 seconds. Hold for 10 seconds. Breathe out.

And here’s the kicker: never use a spacer with a DPI. It blocks the airflow and cuts the dose by 50-70%. Spacers are only for MDIs.

Common Mistakes (And How to Fix Them)

Here’s what most people do wrong-and how to stop it:

• Not shaking the inhaler: 45% of users skip this. Shake it for 5 seconds every time. The medicine settles.
• Exhaling into the device: That blows the medicine out. Always breathe out away from the inhaler.
• Not holding your breath: 63% of people exhale right after inhaling. Hold for 10 seconds. It’s the single biggest upgrade you can make.
• Head tilted too far back or forward: Keep your head level. Tilting it blocks the airway.
• Using too many puffs too fast: Wait a full minute between puffs. Otherwise, you’re just coating your throat.

What to Do After You Inhale

If your inhaler contains a steroid (like fluticasone, budesonide, or beclomethasone), rinse your mouth with water and spit it out. Don’t swallow. This cuts the risk of oral thrush-a fungal infection that causes white patches and soreness-by 75%, according to a 2022 study in Chest Journal.

Also, store your inhaler at room temperature (20-25°C). Heat above 30°C reduces medicine potency by 15-20%. Don’t leave it in your car on a hot day. Don’t put it in the fridge. Room temperature is best.

When to Ask for Help

You shouldn’t have to guess if you’re doing it right. The American Lung Association and the National Asthma Council Australia both say: Ask your doctor or pharmacist to watch you use your inhaler every time you visit.

Studies show that after just three demonstrations with a trained provider, patients improve their technique by 80%. That’s huge. Most people only get one quick demo at diagnosis-and then they’re on their own. Don’t wait until you’re wheezing again. Schedule a 5-minute check-up just for your inhaler technique.

And if you’re still struggling, ask about a smart inhaler. Devices like Propeller Health attach to your inhaler and track when and how you use it. They even send reminders to your phone. A 2022 study in Annals of Internal Medicine found they’re 92% accurate at detecting poor technique.

The Bigger Picture

Inhalers are one of the most common medical devices in the world. Over 250 million are prescribed every year. But in low-income countries, 65% of patients get no training at all. That’s why 3.6 million asthma deaths happen annually-most of them preventable.

Here’s the good news: You can fix this. Right now. Today. You don’t need a new prescription. You don’t need a new device. You just need to learn how to use what you already have.

Take 10 minutes. Watch a video from the American Lung Association or the National Asthma Council Australia. Practice in front of a mirror. Ask someone to watch you. Rinse your mouth. Hold your breath. Wait between puffs.

These aren’t small details. They’re the difference between breathing okay and breathing easy. Between staying out of the hospital and staying home. Between wasting money and getting real results.