Here's information that will help you weigh the pros and cons of different asthma inhalers.

By Mayo Clinic Staff

Asthma inhalers are hand-held, portable devices that deliver medication to your lungs. A variety of asthma inhalers are available to help control asthma symptoms. Finding the right one and using it correctly can help you get the medication you need to prevent or treat asthma attacks.

To find the best inhaler for you, you need to find a balance between the correct medication and the type of inhaler that suits your needs and your ability to use the inhaler correctly. Training from your doctor or other health care provider is essential for learning to use the device you choose correctly.

These inhalers consist of a pressurized canister containing medication that fits into a boot-shaped plastic mouthpiece. With most metered dose inhalers, medication is released by pushing the canister into the boot.

One type of metered dose inhaler releases medication automatically when you inhale. Some metered dose inhalers have counters so that you know how many doses remain. If there's no counter, you'll need to track the number of doses you've used or purchase a separate electronic dose counter to tell when the inhaler is low on medication.

In some cases, such as for children or older adults, using a spacer or valved holding chamber with an inhaler might make it easier to inhale the full dose. A spacer holds medication in a tube between the inhaler and your mouth after it's released. A valved holding chamber is a specialized spacer with a one-way valve to help regulate the flow of medication.

Releasing the medication into the spacer allows you to inhale more slowly, increasing the amount that reaches your lungs. Spacers and holding chambers require a prescription.

There are inhalers with built-in spacers. Others can be used with a spacer that attaches to the inhaler.

Rather than a chemical propellant to push the medication out of the inhaler, you release the medication in these inhalers by breathing in a deep, fast breath. There are multiple-dose devices, which hold up to 200 doses, and single dose devices, which you fill with a capsule before each treatment.

Choosing the asthma inhaler that best meets your needs depends on several factors, including method of delivery and the type of medication you need. Some medications are available only with certain inhaler types. The chart below can help you understand the pros and cons of each type.

Asthma inhaler features
Metered dose inhaler Metered dose inhaler with a spacer Dry powder inhaler
Small and convenient to carry. Less convenient to carry than a metered dose inhaler without a spacer. Small and convenient to carry.
Doesn't require a deep, fast, inhaled breath. Doesn't require a deep, fast, inhaled breath. Requires a deep, fast, inhaled breath.
Accidently breathing out a little isn't a problem. Accidently breathing out a little isn't a problem. Accidently breathing out a little can blow away the medication.
Some inhalers require coordinating your breath with medication release. A spacer makes it easier to coordinate your breath with medication release. Doesn't require coordinating your breath with medication release.
Can result in medication on the back of your throat and tongue. Less medication settles on the back of your throat and tongue. Can result in medication on the back of your throat and tongue.
Some models don't show how many doses remain. Some models don't show how many doses remain. It's clear when the device is running out of medication.
Requires shaking and priming. Requires shaking and priming and correct use of the spacer. Single-dose models require loading capsules for each use.
Humidity doesn't affect medication. Humidity doesn't affect medication. High humidity can cause medication to clump.
Use of a cocking device generally isn't necessary. Use of a cocking device generally isn't necessary. May require dexterity to use a cocking device.

Some people can't use a standard metered dose inhaler or dry powder inhaler. Other types include:

  • Metered dose inhaler with a face mask. Generally used for infants or small children, this type uses a standard metered dose inhaler with a spacer. The face mask, which attaches to the spacer, fits over the nose and mouth to make sure the right dose of medication reaches the lungs.
  • Nebulizer. This device turns asthma medication into a fine mist breathed in through a mouthpiece or mask worn over the nose and mouth. A nebulizer is generally used for people who can't use an inhaler, such as infants, young children, people who are very ill or people who need large doses of medication.
  • Soft mist inhaler

Work with your doctor to determine which type of inhaler will work best for you. Have your doctor, pharmacist or other health provider show you how to use it.

Using your inhaler correctly is critical in ensuring you get the correct dose of medication to keep your asthma under control. Talk to your doctor if you're having trouble using your inhaler, or it seems like you're not getting enough medication.

Replace your inhaler if it has passed its expiration date or it shows that all the doses have been used.

June 30, 2017