Metered-Dose Inhalers (MDI): How to Use

The metered-dose inhaler (MDI) is a canister of medicine that releases a medicated mist. You inhale the mist into the airways of your lungs. The MDI can be used alone, but it is highly recommended that you use a spacer or valved holding device attached to the MDI.

Several different types of medicines are available as MDIs, including:

• bronchodilators (Proventil, Ventolin, Maxair, or Alupent)
• inhaled steroids (Azmacort, AeroBid, or Flovent)
• cromolyn (Intal)
• nedocromil (Tilade)
• ipratropium bromide (Atrovent).

If you are using more than one type of MDI, you will usually use the bronchodilator first.

There are several ways to use an MDI. If you are not using a spacer or valved holding device, the technique most often recommended is as follows:

1. Shake the MDI vigorously.
2. Hold the MDI upright so the mouthpiece is at the bottom.
3. The best way to use the MDI is to hold the mouthpiece 1-and-1/2 to 2 inches in front of an open mouth (about 2 to 3 finger widths). Try this technique first. It helps keep medicine from ending up in your mouth, which may cause increased side effects. It also helps medicine to reach your lungs rather than the back of the throat. If the open mouth technique is too difficult, you may also place the MDI mouthpiece directly into your mouth and close your lips snugly around it. Talk with your provider or pharmacist about this.
4. Breathe out normally.
5. Press the MDI down once so it releases a spray of medicine into your mouth while you breathe in slowly. (One spray is called a puff.)
6. Continue breathing in as slowly and deeply as possible.
7. Hold your breath for 10 seconds or as long as is comfortable (this gives the medicine time to reach the airways).
8. Breathe out slowly.
9. After taking a few normal breaths, repeat steps 1 through 8 for another inhalation (puff) if required. Take the number of puffs prescribed by your healthcare provider.