Inhalers

Easy-to-read information about inhaler devices – what are they, different types available and how to use them.

An inhaler is a device used to deliver medicine to the lungs and airways. It is mainly used to treat or prevent diseases of the airways such as asthma, chronic obstructive pulmonary disease (COPD) or cystic fibrosis. By getting medicine directly to the lungs, smaller doses of medicine are needed and it can start working more quickly.

What are the different types of inhalers?

The main types of inhaler devices are metered dose inhalers and dry powder inhalers.

Metered dose inhalers  

  • Metered dose inhalers are also called MDIs or aerosol inhalers.
  • The medicine is in a small canister, inside a plastic case. When the inhaler is pressed, a measured dose of medicine comes through the mouthpiece.
  • MDIs require good technique and coordination by pressing down on the inhaler and breathing in at the same time.
  • Because using the inhaler correctly can be difficult, spacer devices are recommended for use with MDIs. The spacer is attached to the MDI to make it easier to use the inhaler and get more medicine into the lungs.
  • Read more about metered dose inhalers.

Dry powder inhalers

Deciding on the right inhaler for you

  • Inhaled medicines are an important part of asthma and COPD care.
  • Because inhalers come in many different shapes and sizes, you can find the one that suits you best, by talking with your doctor or asthma educator. Not all medicines are available in all inhalation devices. You may want to try some devices before choosing the one which you are most comfortable with.
Things to consider when choosing an inhaler
Metered dose inhaler (MDI) Advantages
  • Widely available for most inhaled medicines.
  • Small, easy to carry (unless used with a spacer).
Disadvantages
  • Requires good co-ordination technique – have to press down and breathe in at the same time.
  • Recommended to be used with a spacer.
  • Has a propellant that can sometimes cause throat irritation and affects the amount that reaches the lungs.
Learn more about MDIs
Dry powder inhalers such as Turbuhalers, Accuhalers Advantages
  • Does not contain a propellant.
  • Does not require co-ordination of breathing in and pressing down.
Disadvantages
  • Not suitable for young children.
  • Not recommended in people who cannot breathe in strongly enough to inhale the powder.
Learn more about TurbuhalersAccuhalers and the Ellipta inhaler
Inhalation powder in a hard capsule used in an inhaler such Spiriva and Seebri 

Advantages
  • Small and easy to carry around.
  • Does not contain a propellant.
  • Does not require co-ordination of breathing in and pressing down.
Disadvantages
  • Each dose needs to be loaded immediately before use.
  • Requires deep inhalation (breathing in) to receive the full dose from the capsule.
  • Requires second breath to ensure the full dose from the capsule has been inhaled.
Learn more about the Handihaler and Breezhaler
Soft mist inhalers such as Spiriva Respimat, Spiolto Respimat Advantages
  • Compact and easy to carry around.
  • Does not require as much co-ordination of breathing in and releasing the dose, as an MDI.
  • Does not require a spacer.
  • More medication reaches the lung, compared with an MDI.
Disadvantages
  • Every new inhaler must be loaded with a new medicine cartridge.
  • Does need some strength and coordination to assemble the inhaler.  
Learn more about the soft mist inhaler

If the inhaler devices are unsuitable, your doctor may recommend the use of a nebuliser. Read more about nebulisers.

Why is the correct inhaler technique important?

  • To get the most benefit from the medication, it is important to use the correct technique when using your inhaler. This is so you get the right amount of medication and that it reaches deep inside your lungs.
  • Ask your doctor, pharmacist, or nurse to show you how to use your inhaler device.
  • Even if you've had asthma or COPD for a long time and have used the same inhaler for years, it's still worth reminding yourself regularly how they work.
  • Read more about the different types of inhalers: MDIs,  Turbuhaler, Accuhaler, Handihaler, Ellipta inhaler and Breezhaler

Learn more

 Understanding your inhaler The Asthma Foundation, NZ

References

  1. Gupta S. How to ensure the correct inhaler device is selected for each patient.Clinical Pharmacist July/August 2009
  2. Inhaler technique in adults with asthma or COPD. National Asthma Council Australia.
Credits: Sandra Ponen, pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 11 Sep 2018