What is a metered-dose inhaler with a spacer?

A metered-dose inhaler (MDI) is a hand-held device that releases a mist of medicine. Metered dose inhalers contain a gas that helps the medicine get into your lungs. Inhalers help send the medicine directly to your lungs as you take a deep breath.

A device called a spacer can be used with the inhaler. A spacer is a special bag or plastic tube that is attached to the inhaler. Spacers help when it is hard to press the inhaler at the same time that you breathe in the medicine. The spacer holds medicine in the bag or tube and:

• Helps you to breathe at your own pace
• Helps more medicine to reach your lungs
• Keeps medicine from just going into the air

Spacers can be used with or without a mask. Some spacers are made for just one type of inhaler.

How do I use the inhaler with a spacer?

Before the first use, wash the spacer with warm soapy water. Do not rinse. Allow to air dry.

To attach the inhaler to the spacer:

1. Remove the caps from the spacer and metered-dose inhaler.
2. Shake the inhaler well.
3. If the inhaler has not been used before or if it has been more than two weeks since you last used it, you must then “prime” the inhaler. Do this by spraying 2 or 3 sprays of the medicine into the air. Each time you use the inhaler, the next dose is drawn into a chamber inside the inhaler. If the inhaler has not been used or sits for a long time without being used, some of the medicine leaks out of the holding area. This means you will not get the full dose of medicine the next time it is used. Priming the inhaler makes sure that you get the full dose of the medicine.
4. Insert the mouthpiece of the inhaler into the rubber-sealed end of the spacer.

To use the inhaler with the spacer:

1. Stand or sit up straight.
2. Breathe all of the air out of your lungs.
3. Put the spacer into your mouth between your teeth. Make a tight seal around the mouthpiece with your lips.
4. Press the inhaler down once to release a spray of medicine. The medicine will be trapped in the spacer.
5. Just after the mist fills the spacer, breathe in through your mouth slowly for about 5 seconds.
6. Hold your breath for 10 seconds. This gives the medicine time to reach your lower airways. If you are unable to hold your breath, another method is to breathe in and out slowly for 3 to 5 breaths.
7. Take the spacer out of your mouth. Breathe out slowly.
8. If your provider prescribes additional puffs, wait 1 minute and repeat.
9. If you are taking an inhaled steroid medicine, rinse your mouth and spit out the water after the last dose.

How do I clean the inhaler and spacer?

Wash the plastic case for the inhaler once a week with soapy tap water. Rinse well and let the parts air dry.

Wash the spacer once a week with soapy tap water. Do not rinse. Let it air dry.

Replace the one-way valve or get a new spacer when the valve dries out and starts to curl.