Unless one uses a metered dose inhaler correctly, much of the medication may end up on the tongue, on the back of the throat, or in the air. Use of a spacer can help this problem.

A spacer is a device that attaches to a metered-dose inhaler. A spacer holds the medication in its chamber so that it can be inhaled without coordination with breathing. This process helps deliver the medication to the airways where it will be more beneficial. Spacers help people not to cough when using an inhaler. It also helps prevent yeast infections in the mouth when inhaling steroid medications.

Step-by-step instructions on spacer use with a metered dose inhaler

1. Remove caps from the spacer (if there is one) and inhaler.
2. Insert inhaler into the spacer.
3. Shake the inhaler already connected to the spacer.
4. Exhale and place spacer mouthpiece into your mouth and close lips.
5. Press down once on the inhaler.
6. Breathe in slowly and as deeply as you can through your mouth. Breathing in too quickly may result in a whistling sound.
7. Hold your breath for at least 5 seconds or as long as you can.
8. Remove spacer from mouth and breathe out slowly.
9. Remember that if two puffs are ordered, you may wait several minutes between puffs.

Download detailed instructions for Using a Metered Dose Inhaler With a Spacer here.

Cleaning: The spacer should be washed with a drop of mild dish soap and warm water weekly or may be placed on the top shelf of a dishwasher. They should air dry or could be wiped with a lint-free cloth.

Life of a spacer: Life is generally about 1 to 2 years. Spacers containing flap valves should have the valve changed every 6 to 12 months.

Life of an inhaler: Should be tossed after the number of puffs is used. For example, Flovent contains 120 actuations. If 4 puffs are used daily, the inhaler should be tossed after 30 days. Floating of inhalers to determine its contents is not always accurate.