Pulmonology

Resources for Patients

How to Use Inhalers

An inhaler is a tool used to get medicine directly into your lungs. Inhalers come in different shapes and sizes and are filled with prescription medicine and packaged to be sterile (free of germs). Some types of inhalers spray the medicine gently into your lungs. With other types, you take a deep breath to pull the medicine out of the device and into your lungs.

The medicines that go inside inhalers are usually either control medications or rescue medications.

Control medications, such as corticosteroids, are usually taken every day or on a regular schedule, even when you feel healthy. They help to stop lung swelling and prevent you from having a serious episode like an asthma attack.
Rescue medications, like albuterol, work quickly in an emergency situation to help to open your airways and make it easier to breathe.

Inhalers are often used to treat asthma and chronic obstructive pulmonary disease (COPD). Using your inhaler correctly will help you avoid exacerbations of your symptoms or complications for your condition.

In the videos below, available in English and Spanish, family nurse practitioner and pulmonary medicine specialist Alexis F. Gallardo Foreman, DNP, MSN, FNP-BC, shows how to use different types or styles of inhalers. There are also written instructions for each type.

Please reach out to your healthcare team if you have questions.

Different Types of Inhalers

Video Tutorial

Hydrofluoroalkane (HFA) Inhalers with and without Spacers

How to Use Your Inhaler with and without a Spacer (English)

Cómo utilizar su inhalador con y sin espaciador (Español)

HFA Inhalers with Spacer

Your HFA inhaler may be a different color or size, but will be this shape. The following inhalers should be used with a spacer.

Advair HFA: Control Medicine (Fluticasone-Salmeterol)

Photo of an Advair HFA inhaler: purple boot with light purple cap

Instructions for Use

Priming the Inhaler

Hold the inhaler in an upright position and shake the inhaler for 5 seconds.
Face the inhaler away from you and release 4 test sprays.

If you have not used your inhaler in more than 4 weeks, or if you drop it, you must prime it again.

Using the Inhaler with a Spacer

Remove the cap from the inhaler.
Shake the inhaler for 5 seconds.
Attach the inhaler to the end of the spacer. Take the cap off the spacer.
Breathe out all the way.
Place your lips around the spacer and breathe in while pressing down on the inhaler.
Hold your breath for 10 seconds.
Exhale slowly.
After each dose, rinse your mouth with water. Spit the water—do not swallow.

Dulera: Control Medication (Mometasone and Formoterol)

Photo of a Dulera HFA inhaler: blue boot with blue cap

Instructions for Use

Priming the Inhaler

Hold the inhaler in an upright position and shake the inhaler for 5 seconds.
Face the inhaler away from you and release 4 test sprays.

If you have not used your inhaler in more than 4 weeks, or if you drop it, you must prime it again.

Using the Inhaler with a Spacer

Remove the cap from the inhaler.
Shake the inhaler for 5 seconds.
Attach the inhaler to the end of the spacer. Take the cap off the spacer.
Breathe out all the way.
Place your lips around the spacer and breathe in while pressing down on the inhaler.
Hold your breath for 10 seconds.
Exhale slowly.
After each dose, rinse your mouth with water. Spit the water—do not swallow.

Flovent: Control Medication (Fluticasone propionate)

Photo of Flovent HFA inhaler: dark orange boot with orange cap

Instructions for Use

Priming the Inhaler

Hold the inhaler in an upright position and shake the inhaler for 5 seconds.
Face the inhaler away from you and release 4 test sprays.

If you have not used your inhaler in more than 4 weeks, or if you drop it, you must prime it again.

Using the Inhaler with a Spacer

Remove the cap from the inhaler.
Shake the inhaler for 5 seconds.
Attach the inhaler to the end of the spacer. Take the cap off the spacer.
Breathe out all the way.
Place your lips around the spacer and breathe in while pressing down on the inhaler.
Hold your breath for 10 seconds.
Exhale slowly.
After each dose, rinse your mouth with water. Spit the water—do not swallow.

Symbicort: Control Medication (Budesonide and Formoterol)

Photo of a Symbicort HFA inhaler: red boot with gray cap

Instructions for Use

Priming the Inhaler

Hold the inhaler in an upright position and shake the inhaler for 5 seconds.
Face the inhaler away from you and release 4 test sprays.

If you have not used your inhaler in more than 4 weeks, or if you drop it, you must prime it again.

Using the Inhaler with a Spacer

Remove the cap from the inhaler.
Shake the inhaler for 5 seconds.
Attach the inhaler to the end of the spacer. Take the cap off the spacer.
Breathe out all the way.
Place your lips around the spacer and breathe in while pressing down on the inhaler.
Hold your breath for 10 seconds.
Exhale slowly.
After each dose, rinse your mouth with water. Spit the water—do not swallow.

HFA Inhalers without Spacer

Your HFA inhaler may be a different color or size, but will be this shape.

(Some of these inhalers can also be used with a spacer. See below for details.)

ProAir HFA: Rescue Medication (Albuterol)

Photo of a ProAir HFA inhaler: red boot with white cap

Instructions for Use

Priming the Inhaler

Hold the inhaler in an upright position and shake the inhaler for 5 seconds.
Face the inhaler away from you and release 4 test sprays.

If you have not used your inhaler in more than 4 weeks, or if you drop it, you must prime it again.

Using the Inhaler (Can Be Used with a Spacer)

Remove the cap from the inhaler.
Shake the inhaler for 5 seconds.
Breathe out all the way.
Place your lips around inhaler and breathe in while pressing down on the inhaler.
Hold your breath for 10 seconds.
Exhale slowly.
Recap inhaler.

Proventil: Rescue Medication (Albuterol)

Photo of a Proventil HFA inhaler: yellow boot with orange cap

Instructions for Use

Priming the Inhaler

Hold the inhaler in an upright position and shake the inhaler for 5 seconds.
Face the inhaler away from you and release 4 test sprays.

If you have not used your inhaler in more than 4 weeks, or if you drop it, you must prime it again.

Using the Inhaler (Can Be Used with a Spacer)

Remove the cap from the inhaler.
Shake the inhaler for 5 seconds.
Breathe out all the way.
Place your lips around inhaler and breathe in while pressing down on the inhaler.
Hold your breath for 10 seconds.
Exhale slowly.
Recap inhaler.

Ventolin: Rescue Medication (Albuterol)

Photo of a Ventolin HFA inhaler: blue boot with navy blue cap

Instructions for Use

Priming the Inhaler

Hold the inhaler in an upright position and shake the inhaler for 5 seconds.
Face the inhaler away from you and release 4 test sprays.

If you have not used your inhaler in more than 4 weeks, or if you drop it, you must prime it again.

Using the Inhaler (Can Be Used with a Spacer)

Remove the cap from the inhaler.
Shake the inhaler for 5 seconds.
Breathe out all the way.
Place your lips around inhaler and breathe in while pressing down on the inhaler.
Hold your breath for 10 seconds.
Exhale slowly.
Recap inhaler.

Xopenex: Rescue Medication (Levalbuterol)

Photo of a Xopenex HFA inhaler: light blue with red cap

Instructions for Use

Priming the Inhaler

Hold the inhaler in an upright position and shake the inhaler for 5 seconds.
Face the inhaler away from you and release 4 test sprays.

If you have not used your inhaler in more than 4 weeks, or if you drop it, you must prime it again.

Using the Inhaler (Can Be Used with a Spacer)

Remove the cap from the inhaler.
Shake the inhaler for 5 seconds.
Breathe out all the way.
Place your lips around inhaler and breathe in while pressing down on the inhaler.
Hold your breath for 10 seconds.
Exhale slowly.
Recap inhaler.

ProAir RespiClick: Rescue Medication (Albuterol sulfate)

Instructions for Use

Hold the inhaler upright and open the red cap fully until you feel and hear a “click.”
Each time you open the red cap and it “clicks,” a dose is ready to be inhaled.
Breathe in quickly and deeply through your mouth to deliver the dose of medicine to your lungs.
Remove the inhaler from your mouth.
Hold your breath for about 10 seconds, or for as long as you comfortably can.
The inhaler delivers your dose of medicine as a very fine powder that you may or may not taste or feel. Do not take an extra dose from the inhaler even if you do not taste or feel the medicine.
Close the red cap firmly over the mouthpiece.
Make sure you close the red cap after each inhalation, so that the inhaler will be ready for your next dose.
If you need another dose, close the red cap and then repeat the above steps.

Diskus Inhalers

Your diskus inhaler may be a different color or size, but will be this shape.

Video: How to Use Your Diskus Device (English)

Video: Cómo utilizar el dispositivo Diskus (Español)

Advair: Control Medication (Fluticasone and Salmeterol)

Photo of an Advair Diskus inhaler device: dark purple disk with light purple lever

Instructions for Use

Hold the device in one hand, making sure it is level.
Put the thumb of your other hand on the notch and push towards the back until it snaps and the mouthpiece and lever are revealed.
Slide the lever away from you until it clicks. (This loads the medication.)
Turn away from the diskus and breathe out as much air as you comfortably can.
Put the mouthpiece in your mouth and breathe in as steadily and deeply as you can.
Remove the diskus from your mouth, holding your breath for 5 to 10 seconds.
Breathe out slowly.
Close the diskus by sliding the thumb grip towards you.
Rinse your mouth with water. Spit out the water—do not swallow.

Do not get this inhaler wet.

Flovent: Control Medication (Fluticasone)

Photo of a Flovent Diskus inhaler device: orange disk with orange lever

Instructions for Use

Hold the device in one hand, making sure it is level.
Put the thumb of your other hand on the notch and push towards the back until it snaps and the mouthpiece and lever are revealed.
Slide the lever away from you until it clicks. (This loads the medication.)
Turn away from the diskus and breathe out as much air as you comfortably can.
Put the mouthpiece in your mouth and breathe in as steadily and deeply as you can.
Remove the diskus from your mouth, holding your breath for 5 to 10 seconds.
Breathe out slowly.
Close the diskus by sliding the thumb grip towards you.
Rinse your mouth with water. Spit out the water—do not swallow.

Do not get this inhaler wet.

SereVent: Controller Medication (Salmeterol)

Photo of a SereVent Diskus inhaler device: green disk with green lever

Instructions for Use

Hold the device in one hand, making sure it is level.
Put the thumb of your other hand on the notch and push towards the back until it snaps and the mouthpiece and lever are revealed.
Slide the lever away from you until it clicks. (This loads the medication.)
Turn away from the diskus and breathe out as much air as you comfortably can.
Put the mouthpiece in your mouth and breathe in as steadily and deeply as you can.
Remove the diskus from your mouth, holding your breath for 5 to 10 seconds.
Breathe out slowly.
Close the diskus by sliding the thumb grip towards you.
Rinse your mouth with water. Spit out the water—do not swallow.

Do not get this inhaler wet.

Ellipta Inhalers

Your Ellipta inhaler may be a different color or size, but will be this shape.

Video: How to Use Your Ellipta Device (English)

Video: Cómo utilizar el dispositivo Ellipta (Español)

Anoro Ellipta: Control Medication (Umeclidinium and Vilanterol)

Photo of an Anoro Ellipta inhaler device: gray device with hot pink lever

Instructions for Use

Open
- Slide the cover down until you hear a “click.”
- While holding the inhaler away from your mouth, breathe out as far as is comfortable.
Inhale
- Put the mouthpiece between your lips, and close your lips firmly around it.
- Take one long, steady, deep breath in, and hold this breath for at least 3 to 4 seconds.
Close
- Remove the inhaler from your mouth and breathe out slowly and gently.
- Slide the cover upwards as far as it will go to cover the mouthpiece.

Do not get this inhaler wet.

Arnuity Ellipta: Control Medication (Fluticasone furoate)

Photo of an Arnuity Ellipta inhaler device: white device with orange lever

Instructions for Use

Open
- Slide the cover down until you hear a “click.”
- While holding the inhaler away from your mouth, breathe out as far as is comfortable.
Inhale
- Put the mouthpiece between your lips, and close your lips firmly around it.
- Take one long, steady, deep breath in, and hold this breath for at least 3 to 4 seconds.
Close
- Remove the inhaler from your mouth and breathe out slowly and gently.
- Slide the cover upwards as far as it will go to cover the mouthpiece.

Do not get this inhaler wet.

Breo Ellipta: Control Medication (Fluticasone and Vilanterol)

Photo of an Breo Ellipta inhaler device: grey device with light blue lever

Instructions for Use

Open
- Slide the cover down until you hear a “click.”
- While holding the inhaler away from your mouth, breathe out as far as is comfortable.
Inhale
- Put the mouthpiece between your lips, and close your lips firmly around it.
- Take one long, steady, deep breath in, and hold this breath for at least 3 to 4 seconds.
Close
- Remove the inhaler from your mouth and breathe out slowly and gently.
- Slide the cover upwards as far as it will go to cover the mouthpiece.

Do not get this inhaler wet.

Incruse Ellipta: Control Medication (Umeclidinium)

Photo of an Incruse Ellipta inhaler device: white device with light green lever

Instructions for Use

Open
- Slide the cover down until you hear a “click.”
- While holding the inhaler away from your mouth, breathe out as far as is comfortable.
Inhale
- Put the mouthpiece between your lips, and close your lips firmly around it.
- Take one long, steady, deep breath in, and hold this breath for at least 3 to 4 seconds.
Close
- Remove the inhaler from your mouth and breathe out slowly and gently.
- Slide the cover upwards as far as it will go to cover the mouthpiece.

Do not get this inhaler wet.

Trelegy Ellipta: Control Medication (Fluticasone, Umeclidinium, and Vilanterol)

Photo of a Trelegy Ellipta inhaler device: white device with beige lever

Instructions for Use

Open
- Slide the cover down until you hear a “click.”
- While holding the inhaler away from your mouth, breathe out as far as is comfortable.
Inhale
- Put the mouthpiece between your lips, and close your lips firmly around it.
- Take one long, steady, deep breath in, and hold this breath for at least 3 to 4 seconds.
Close
- Remove the inhaler from your mouth and breathe out slowly and gently.
- Slide the cover upwards as far as it will go to cover the mouthpiece.

Do not get this inhaler wet.

HandiHaler Inhaler

Your HandiHaler inhaler will look like this one.

Video: How to Use Your HandiHaler Device (English)

Video: Cómo utilizar su dispositivo HandiHaler (Español)

Spiriva HandiHaler: Control Medication (Tiotropium)

Photo of a Spiriva HandiHaler inhaler device: grey device with green button

Instructions for Use

Open the dust cap, then the mouthpiece.
Insert the capsule in the chamber.
Close the mouthpiece firmly until you hear a click.
Press the green button once to pierce the capsule, then release.
Breathe out.
With your lips tightly around mouthpiece, inhale deeply and slowly.
Hold for 10 seconds.
Repeat.

Do not get this inhaler wet.

Respimat Inhalers

Your Respimat inhaler may be a different color or size, but will be this shape.

Video: How to Use Your Respimat Device (English)

Video: Cómo utilizar el dispositivo Respimat (Español)

Spiriva Respimat: Control Medication (Tiotropium)

Photo of a Spiriva Respimat inhaler device: grey inhaler with blue green cap

Instructions for Use

Inserting the Cartridge
- With the cap closed, press the safety catch while removing the clear base.
- Push the narrow end of the cartridge into the inhaler until it clicks. Push the cartridge firmly against a surface.
- Press the dose-release button, and repeat this process until a cloud of mist is visible.
Priming the Inhaler
- With the cap closed, hold the inhaler upright and turn the clear base to the right until it clicks.
- Open the cap until it snaps open and point the inhaler towards the ground. Press dose-release button until mist is visible.
- Put the clear base back on the device. It should click into place. The clear base should not be removed after this step.

For Daily Use

Turn. Keep the cap closed. Turn the base to the right until you hear a click.
Open. Pull the cap open, and breathe out.
Press. Close your lips around the mouthpiece without covering the air vents. Inhale deeply through your mouth, press the dose-release button, and continue to breathe in slowly. Hold your breath for 10 seconds, then exhale.

Combivent Respimat: Rescue Medication (Ipratropium)

Photo of a Combivent inhaler device: grey inhaler with orange cap

Instructions for Use

Inserting the Cartridge
- With the cap closed, press the safety catch while removing the clear base.
- Push the narrow end of the cartridge into the inhaler until it clicks. Push the cartridge firmly against a surface.
- Press the dose-release button, and repeat this process until a cloud of mist is visible.
Priming the Inhaler
- With the cap closed, hold the inhaler upright and turn the clear base to the right until it clicks.
- Open the cap until it snaps open and point the inhaler towards the ground. Press dose-release button until mist is visible.
- Put the clear base back on the device. It should click into place. The clear base should not be removed after this step.

For Daily Use

Turn. Keep the cap closed. Turn the base to the right until you hear a click.
Open. Pull the cap open, and breathe out.
Press. Close your lips around the mouthpiece without covering the air vents. Inhale deeply through your mouth, press the dose-release button, and continue to breathe in slowly. Hold your breath for 10 seconds, then exhale.