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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medically reviewed by WellAlly Editorial TeamLast reviewed October 19, 2026Editorial policy
Medication23 min read

How to Use a Metered-Dose Asthma Inhaler with a Spacer Correctly

Published: October 19, 2026Updated: October 19, 2026

Using a spacer or valved holding chamber with your metered-dose inhaler ensures that medication reaches deep into your lungs rather than getting trapped in your mouth or throat. This step-by-step guide walks you through proper preparation, inhalation technique, and maintenance to maximize your asthma control. Following these evidence-based steps will help minimize side effects and improve drug delivery.

Quick Summary

Using a spacer with your metered-dose inhaler delivers more medicine directly into your lungs while reducing systemic side effects and oral irritation.

Important Medical Disclaimer

This guide is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with qualified healthcare providers for medical concerns.

Step-by-Step Guide

1

Inspect and Prepare the Devices

Remove the protective caps from both the metered-dose inhaler (MDI) mouthpiece and the spacer. Look inside both devices to ensure there are no foreign objects, lint, or dust particles present. Shake the inhaler vigorously up and down for 5 seconds to thoroughly mix the propellant and active medication.

Important: If the inhaler has not been used for several days or is brand new, prime it by spraying test puffs into the air according to the manufacturer's directions.

2

Connect the Inhaler to the Spacer

Insert the mouthpiece of the inhaler firmly into the flexible rubber or silicone opening at the back of the spacer. Ensure the inhaler canister is standing upright and seated snugly to create an airtight seal. Hold the combined device level so the medication can disperse evenly throughout the chamber.

3

Exhale Completely Away from the Device

Sit or stand up straight to allow your lungs to expand fully. Turn your head away from the spacer mouthpiece and breathe out gently until your lungs feel empty. Do not exhale into the spacer chamber, as internal moisture can cause medication particles to clump and adhere to the walls.

4

Position the Mouthpiece and Form a Tight Seal

Place the spacer mouthpiece into your mouth between your upper and lower teeth, resting your tongue flat so it does not block the opening. Close your lips firmly around the mouthpiece to form a complete, airtight seal. Keep your chin level and ensure your fingers are not obstructing any exhalation valves on the chamber.

5

Actuate the Inhaler and Inhale Slowly

Press down on the inhaler canister once to release a single puff of medication into the spacer chamber. Immediately begin breathing in through your mouth slowly and deeply over a period of 3 to 5 seconds. Inhaling too rapidly creates turbulence that causes medication to deposit in your upper throat instead of the lower airways.

Important: If your spacer produces a high-pitched whistling sound, you are inhaling too fast; slow your breath down until the sound stops.

6

Hold Your Breath

Remove the spacer mouthpiece from your mouth and close your lips. Hold your breath for 10 seconds, or for as long as is comfortably possible, to give the microscopic aerosol droplets time to settle deep into your bronchial airways. Exhale gently and return to normal breathing.

7

Wait Before Taking a Second Puff

If your healthcare provider prescribed two puffs of medication, wait approximately 30 to 60 seconds before repeating the process. Shake the inhaler again before administering the second dose and repeat steps 3 through 6. Administering puffs separately ensures consistent dosing and proper lung deposition.

Important: Never press the canister twice into the chamber at the same time; doing so causes droplets to collide and stick to the chamber walls, reducing the delivered dose.

8

Rinse Your Mouth and Store the Device

If your inhaler contains a corticosteroid, rinse your mouth thoroughly with water and spit it out to prevent fungal infections and voice hoarseness. Wipe the spacer mouthpiece clean with a dry tissue and replace the protective caps on both devices. Store the equipment in a clean, dry location away from extreme temperatures.

Important: Always spit the rinse water out; do not swallow it, as doing so increases the systemic absorption of steroid medication.

Frequently Asked Questions

Why should I use a spacer instead of inhaling directly from the inhaler?
A spacer slows down the high-speed aerosol spray and suspends the medication droplets in a chamber. This eliminates the need for perfect coordination between pressing the canister and inhaling, and it allows significantly more medicine to reach deep into your lungs rather than landing on the back of your throat.
Can I spray two puffs into the spacer at the same time?
No. Spraying multiple puffs at once causes aerosol droplets to collide and stick to the plastic walls of the chamber. This drastically reduces the amount of active medication available for you to inhale, rendering the dose subtherapeutic.
How often and how should I clean my spacer?
Clean your spacer approximately once every week to two weeks. Disassemble it and soak the parts in warm water with mild dish soap for 15 minutes without scrubbing, then rinse gently and let all components air-dry completely on a clean rack or towel to prevent static buildup.
What should I do if my child cannot hold their breath after inhaling from a spacer?
If a child or infant cannot perform a single deep breath and breath-hold, attach a properly fitted face mask to the spacer and let them take 5 to 6 normal, calm tidal breaths from the chamber for each single puff of medication released.
  1. 1
    Centers for Disease Control and Prevention (CDC)Source
  2. 2
    National Heart, Lung, and Blood Institute (NHLBI)Source
  3. 3
    National Health Service (NHS)Source
  4. 4
    Mayo ClinicSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed October 19, 2026. · Read our editorial policy