How to give medicines: inhalers for asthma

This page provides instructions on how to use inhalers for asthma. These include ‘preventer inhalers’, which are used regularly in order to prevent attacks (this is sometimes called asthma prophylaxis), and ‘reliever inhalers’, which are used during an asthma attack. Specific information about individual medicines is available on the medicines information pages.

This page explains how to use inhalers with your child. Read the information or watch the video all the way to the end before doing this for the first time.

There are many types of inhalers. An instruction leaflet will also be provided with your child’s inhaler. This will tell you how to put the inhaler together and how to use it.

If you are not sure whether you are using the inhaler properly, or need help, contact your asthma nurse or pharmacist, who will be able to show you or check what you are doing.

Using a pressurised inhaler with a ‘spacer’ device

  • Pressurised inhalers are often used with a device called a spacer, so that the medicine is breathed into the lungs more easily.
    • A spacer is a sealed, empty container that an inhaler can be connected to. The spacer acts as a collecting chamber that the asthma medicine is released into and inhaled slowly, without needing to get the timing and speed exactly right. The correct way to use a pressurised inhaler and spacer is described below.
  • Some spacers come with a face mask. Talk to your asthma nurse or pharmacist about the best type of spacer device for your child.
  • For older children, they could try a breath-actuated dry powder inhaler (instructions for how to use these is in the next section).

The following instructions are for most pressurised inhalers with a ‘spacer’ device.

  • Put the spacer device together, following the instructions that come with it.
  • For a young child, attach the mask to the spacer mouth piece. If your child can hold the spacer mouthpiece in their mouth and hold it firmly between their lips, creating a good seal, you may not need to use the mask.
  • Some spacers (e.g. aerochambers) only come with a mask or a mouth piece. If you are unsure, check with your asthma nurse or pharmacist that you have the best type of inhaler for your child.
  • Take the cap off the inhaler, making sure that the mouth piece is clean.
  • While holding the inhaler upright, place your thumb on the bottom of the inhaler and your first finger on the top. Then shake the inhaler several times up and down.
  • If the inhaler is new or has not been used for three days or more, release one puff into the air before use.
  • Insert the mouth piece of the inhaler into the spacer. It should fit easily and securely.
  • Place the mouthpiece in your child’s mouth (or mask over your child’s mouth and nose, ensuring a good seal with the skin around the mouth). Reassure your child during this step, as they may be distressed.
  • Encourage your child to breathe in slowly and gently.
  • Press down once on the aerosol canister with the first finger. This releases one puff into the spacer.
  • If your child is using a mask hold it in place and count to 20 encouraging your child to breath normally. If they are not using a mask encourage them to take five deep and slow breaths in and out. It is important not to rush this step.
  • Remove the spacer from your child’s mouth. If more than one dose/puff is required, shake the inhaler, wait 30 seconds before repeating the previous steps.
  • Your child should rinse their mouth out thoroughly with water or clean their teeth.

How to use a breath-actuated (dry powder) inhaler

  • Breath-actuated means that it is the force of breathing-in that releases the dose of medicine from the inhaler.
  • A hard, fast breath is necessary to draw the medicine into the lungs.
  • Breathing in too slowly might mean the medicine does not work properly. Some inhalers will show when the dose is released properly, for example by a ‘click’ sound or a green indicator.
  • There are many different types of dry-powder inhaler: e.g. Accuhaler, Clickhaler, Diskhaler, Easyhaler, Novolizer, Turbohaler, and Twisthaler.
  • These inhalers are not used with a spacer.
  • Most breath-actuated (dry powder) inhalers need to be ‘primed’ or loaded before breathing in. Follow the instructions that come with your inhaler for how to get it ready. If you are not sure how to do this, ask your pharmacist or nurse to show you.

The following instructions are for most breath-actuated (dry-powder) inhalers.

  • Load the dose as instructed in the manufacturer’s leaflet.
  • Ask your child to breathe out normally, as far as they can. Place the mouthpiece of the inhaler firmly between the lips, ensuring a good seal around the mouthpiece.
  • Ask your child to breathe in quickly and deeply to release the dose from the inhaler.
  • Take the inhaler out of your child’s mouth. They should close their mouth and hold their breath for 5–10 seconds, or for as long as they can comfortably manage. They can then breathe normally. It is important not to rush this step.
  • If your child has to take more than one puff, they should breathe normally for a minute or so before giving the next one.
  • Your child should rinse their mouth out thoroughly with water or clean their teeth.

How do I keep an inhaler clean?

  • Each inhaler (and spacer device, if used) will come with instructions about how to keep them clean. Generally you can take the spacer apart, wash it in warm, soapy water and leave it to air dry.
  • Do not dry any parts with a towel or similar as this can create a static charge, which can prevent the medicine from reaching the lungs.

Where should I keep the inhaler?

  • Your child should have their ‘reliever inhaler’ with them at all times in case they have an asthma attack.
  • Your child should always keep the inhaler cap on when they are not using it.
  • Extreme temperatures and high altitudes can affect the medicine in the inhaler. Don’t leave the inhaler where it might get too hot or too cold e.g on a sunny window sill or in a car on a very hot or cold day.
  • Dry powder inhalers need to be kept dry so should not be stored in a bathroom.

Who to contact for more information

Your child’s doctor, pharmacist or nurse will be able to give you more information about your child’s medicine for asthma.
You can also get useful information from:
England: NHS 111 -Tel 111 –
Scotland: NHS 24 – Tel 111 –
Wales: NHS 111 Wales – Tel 111 –
Northern Ireland: NI Direct –
Asthma + Lung UK: Helpline 0800 300 222 5800 –

You can read further information about individual medicines by searching (A-Z) on the Medicines Information pages on this website.