How To Use Your Metered Dose Inhaler

Do You Know If You ARe Using Your MDI Correctly

Man using a metered dose inhaler

Have you ever wondered how to use your metered dose inhaler (MDI) correctly? Or if you are using it correctly?

I can tell you it is not as easy as it sounds or looks. I had a professor tell me once that he would take me to any restaurant I wanted if I could perfectly demonstrate correct MDI use at the end of my one month long rotation. As you might guess, I failed!!

This potentially impacts your asthma control as poor technique leads to decreased meds to your lungs.

Proper technique is an essential part of your asthma action plan.

Technique and Your Doctor

Your doctor should be assessing your asthma technique. However, many primary care physicians have the same knowledge/ technique problem that I had during my residency and just don’t know how to do it. If this is the case you may want to consider seeing an asthma educator to make sure your technique is where it needs to be.

What Is A Metered Dose Inhaler?

The MDI is one of the ways that your asthma medication gets into your lungs. The MDI will release a fine mist of medication after actuation and the goal is to inhale the medication into your lungs.

However, with poor technique more of the medication will end up in your mouth and not where it will improve symptoms such as:

How Does The Medication Get Into My Lungs

MDIs are powered by a propellant that pushed the medication out of your MDI into aerosolized form.

In 2009 in an effort to decrease chlorofluorocarbon (CFC) exposureand make us more green, CFC inhalers were switched to hydroflouroalkane (HFA) inhalers. In fact, CFC inhalers were no longer allowed to be produced by law.

How Do I Use My MDI

The best technique involves a spacer or a holding chamber that allows you to get more medication to your lungs with less dependence on technique.

However, if you do not have a spacer available you will need to follow these steps:

  1. Shake the MDI vigorously in order to mix your medication correctly.

  2. You will need to prime the inhaler if you have not used it previously. In order to do this you will need to press the actuation button 2–3 times (it is probably best look at your medication’s package insert to see how the manufacturer recommends you do this. The next dose is automatically pushed into the chamber following use.

    If an inhaler sits for a long time without use, (hopefully the case with your rescue inhaler, some medication will leak out. This means that you may not get a full dose.

  3. Hold the inhaler straight up and down with the mouthpiece at the bottom.

  4. Position the mouth piece 2–3 finger widths in front of your open mouth. This avoids deposition of medication into the mouth or the back of the throat and allows for more medication to reach your lungs.

    The problem I and many patients have with this technique is that it requires you to then time actuation of the inhaler with your breath as described below. If this is too difficult you can place your lips around the mouth piece and actuate. Make sure to discuss with your doctor as it is a suboptimal technique and increases potential side effects of some medications.

  1. Breathe out normally with your head tilted back slightly.

  2. Press down slowly to actuate your inhaler and begin a slow and deep breathe in.

  3. Continue to breathe slowly and deeply for 3–5 breaths.

  4. Hold you breath for 10 seconds in order to help get and keep medication to your lungs.

  5. Breathe normally.

  6. Repeat steps 1–9 depending on the number of puffs prescribed by your doctor.

If the medication you are taking is an inhaled steroid that make sure you follow steps to avoid side effects. Make sure you appropriately clean your inhaler weekly by rinsing the plastic case and allowing to completely dry.

What Is Your Biggest Asthma Problem?

We want to help you get control of your asthma. I want to hear about your biggest asthma problem so that we can try to help you develop a solution or better understand how to help.
 You are probably not the only one with the problem. Take a few minutes describing your problem so we can develop a solution together.

Learn More About Your Asthma

Feel free to email me email me with any questions or problems. If you found this article helpful please consider sharing it to your preferred social network with one of the social sharing buttons.


  1. National Heart, Lung, and Blood Institute. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma. Accessed on April 3, 2015.

Continue Reading