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Top 10 Inhaler Mistakes Adults Make

This information has been reviewed and approved by Flavia Cecilia Lega Hoyte, MD (May 2022).

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Summary: Top 10 Inhaler Mistakes Adults Make

Inhaled asthma medicine needs to reach the airways to work.
Here are 10 common mistakes made when using a
metered-dose inhaler (MDI) and how to correct them.

1. Slouching

FIX IT: Sitting up straight or standing allows the lungs to fully inhale and provides more power to exhale.

2. Using an empty inhaler

FIX IT: Request a refill when the inhaler has 30 puffs or doses left.

3. Not shaking or priming the inhaler*

FIX IT: Shake the inhaler canister vigorously (about 10 to 15 times) for the medication to be ready to work. When using a new inhaler, prime it by releasing three to four test sprays. Prime again if not used for several weeks. *This tip applies to MDI inhalers. Diskus or dry powder inhalers do not require shaking.

4. Using an MDI inhaler without a spacer

FIX IT: A spacer helps more of the medicine get to the airways. Insert the inhaler into the spacer. Spray one puff of medicine and inhale slowly. Hold your breath for a count of 10 and exhale slowly.

5. Spraying several puffs of inhaler into spacer

FIX IT: Spray only one puff of the inhaler into the spacer for each breath. Breathe out before inhaling. Inhale and hold your breath for a count of 10, then exhale. Repeat for the number of puffs the doctor prescribed.

6. Holding the head too far forward or backward

FIX IT: The head needs to be in a normal position, not too far back or too far forward, to help make a direct path for the medicine to reach the airways.

7. Tongue or teeth in the way of spacer/inhaler opening

FIX IT: Put the mouthpiece of the spacer/inhaler in the mouth above the tongue, under the top teeth.

8. Mouth not tight enough around spacer/inhaler

FIX IT: Close the lips around the mouthpiece of the spacer or inhaler so air does not escape.

9. Directing spacer/inhaler at tongue or roof of mouth

FIX IT: Aim the spacer/inhaler at the back of the throat, so the medicine reaches the lungs.

10. Inhaling medicine too fast

FIX IT: Inhale slowly. A whistle sound made when using a spacer means the inhalation is too fast.

These tips are not applicable to breath-activated and powder inhalers.


  • Follow instructions for using your inhaler.
  • Gargle and spit after inhaling a steroid.
  • Show your inhaler technique to your provider.
  • Clean the inhaler and spacer according to instructions.

Asthma Facts

  • 1 in 11 adults has asthma
  • One-third of adults with asthma miss work
  • Most prevalent among ages 18-24
  • 10 asthma deaths occur each day

More Information on Asthma


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