Inhaler Types and Technique: A GP Guide
Inhalers are commonly used for asthma, COPD, wheeze and other breathing conditions. They deliver medication directly into the lungs, but they only work well if the inhaler type, dose and technique are right for the person using them.
Many adults are prescribed inhalers for years without feeling fully confident about how they should be used. Some people are unsure which inhaler is their reliever, which is their preventer, whether they should be using a spacer, or whether their symptoms mean their treatment needs review.
This page explains the main types of inhalers, why technique matters, common mistakes and when to seek GP advice.
These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help, please book an appointment with one of our GP’s.
Why inhaler technique matters
An inhaler only works if the medication reaches the small airways deep in the lungs. When technique is poor, much of the dose lands in the mouth and throat or is lost to the air. This can mean:
- symptoms stay poorly controlled despite regular use
- higher doses or extra medicines are prescribed unnecessarily
- a greater chance of side effects, such as oral thrush or a hoarse voice from inhaled steroids
Getting technique right often improves control without any change in medication. It is one of the first things a GP will review when an inhaler does not seem to be helping.
The main types of inhaler
Inhaler devices fall into a few broad groups. The best device for a given person depends on their condition, their ability to coordinate breathing with the device and their personal preference. There is no single “best” inhaler.
Many people use two inhalers: a preventer, taken every day to reduce inflammation in the airways, and a reliever, used when symptoms flare. Some people use a single combination inhaler for both, known as MART. Knowing which is which, and how each should be used, is an important part of staying well.
Inhaler devices at a glance
Below is a summary of the main device types used in UK primary care. A GP, practice nurse or pharmacist can help you find a device you are able to use well.
Metered dose inhalers (MDIs)
A pressurised canister in a plastic holder. Pressing the canister releases a measured puff of medication. They are compact and widely used, but you need to press and breathe in at the same time, which a spacer makes much easier.
Dry powder inhalers (DPIs)
The medication is a fine powder, drawn into the lungs by a quick, deep breath in. There is no need to press and breathe at the same time, but you do need to be able to breathe in strongly.
Breath-actuated inhalers
These release the dose automatically when you breathe in, so you do not have to press and inhale at the same time. They can suit people who find a standard MDI difficult to coordinate.
Soft mist inhalers
These release the medication as a slow-moving mist over a longer period, which can make it easier to inhale the full dose. They are used for certain long-term treatments.
Spacers
A spacer is a hollow chamber that attaches to an MDI. You breathe the puff in over a few breaths, so timing matters less and more medication reaches the lungs.
Combination (MART) inhalers
Some people with asthma use one inhaler as both their regular preventer and their reliever. If this is your plan, follow the instructions agreed with your GP or at your asthma review.
What is a spacer, and who benefits?
A spacer is a hollow chamber that attaches to a metered dose inhaler. The puff of medication is released into the chamber and then breathed in over a few breaths, rather than needing to be inhaled at the exact moment the device is pressed. Spacers help because they:
- remove the need for precise coordination
- increase the amount of medication reaching the lungs
- reduce the amount left in the mouth and throat, lowering the risk of side effects from inhaled steroids
Spacers are particularly useful for older adults, anyone who finds a standard MDI difficult to use, and during a flare-up, when coordination is harder.
How to use a metered dose inhaler correctly
Technique varies slightly between devices, and you should always follow the specific instructions for your inhaler. As a general guide, using an MDI usually involves:
- removing the cap and shaking the inhaler
- breathing out gently, away from the device
- sealing your lips around the mouthpiece
- pressing the canister once as you begin to breathe in slowly and steadily
- continuing to breathe in fully, then holding your breath for around ten seconds if you can
- waiting about thirty seconds before a second puff, if one is prescribed
If you use an inhaled steroid, rinsing your mouth and spitting out afterwards helps reduce the risk of oral thrush and a hoarse voice.
How to use a dry powder inhaler correctly
Dry powder inhalers rely on a fast, strong breath in rather than a slow one. General steps usually include:
- loading the dose according to the device instructions
- breathing out gently, away from the device (not into it, as moisture can clog the powder)
- sealing your lips around the mouthpiece
- breathing in quickly and deeply
- holding your breath for around ten seconds if you can
Because the technique differs from an MDI, people who switch device types sometimes use the new one incorrectly out of habit. It is worth having your technique checked whenever your device changes.
A note on combination (MART) inhalers
Some people with asthma are prescribed a single inhaler that is used both regularly, as a preventer, and as needed, for symptom relief. This approach is known as MART (maintenance and reliever therapy). With MART:
- you use the same inhaler for your regular doses and when symptoms flare
- using it as needed is part of the plan, within the limits your clinician has set
- your personal asthma plan should say the most you should use in a day
Because of this, what counts as using your inhaler too much is different from a traditional separate reliever. Follow the plan agreed with your GP or at your asthma review, and seek advice if you regularly need more than your plan allows.
Common inhaler technique mistakes
Common problems include breathing in too fast with an MDI, too gently with a dry powder inhaler, forgetting to shake an MDI, and not noticing when a device is nearly empty. A few simple habits help:
- have your technique checked from time to time, especially if your symptoms are not well controlled
- if you use a separate reliever inhaler, keep track of how often you need it, as increasing use can be a sign that control is slipping
- know when your inhaler is running low and order a replacement in good time
- store devices as directed and keep spacers clean
If you are relying on your reliever more than usual, or feel your symptoms are not well controlled, it is worth reviewing this with a GP rather than simply carrying on.
When to seek help
Inhaler technique problems are common and usually straightforward to correct. However, you should seek prompt advice if:
- you are needing your reliever more often than usual, or more than your plan allows
- your symptoms are waking you at night or limiting your normal activities
- you feel your treatment is no longer controlling your symptoms
If you have severe breathlessness, cannot speak in full sentences, or your reliever is not helping during an attack, call 999 or seek emergency care immediately.
Frequently asked questions
How do I know if I am using my inhaler correctly?
Many people use their inhaler incorrectly without realising. The most reliable way to check is to have your technique reviewed by a clinician, who can watch you use the device and correct any issues. Poor technique is a common reason an inhaler seems less effective than expected.
Do I need a spacer with my inhaler?
Not everyone does, but spacers make metered dose inhalers easier and more effective to use, and they reduce the risk of side effects from inhaled steroids. They are especially helpful for older adults and during flare-ups. A GP can advise whether a spacer would benefit you.
Why does my inhaler feel like it has stopped working?
The most common reasons are incorrect technique, an empty or nearly empty device, or worsening of the underlying condition. If your usual inhaler no longer seems to control your symptoms, it is worth a review rather than simply using it more often.
Should I rinse my mouth after using my inhaler?
If you use an inhaled steroid, rinsing your mouth and spitting out afterwards helps reduce the risk of oral thrush and a hoarse voice. This is not necessary for reliever inhalers that do not contain a steroid.
Can I use someone else’s inhaler?
No. Inhalers contain different medicines at different doses, and using one that has not been prescribed for you can be unsafe. If you have run out or think you need an inhaler, seek advice rather than borrowing one.
Further Reading and Hub Links
Visit our Lung Health hub or browse more health topics in the AccessGP Knowledge Base. You may also find our guide to respiratory medicines and inhalers helpful. For more on asthma, see the NHS guide to asthma.
If you would like a GP to review your inhaler technique, check whether your treatment is working well or discuss your breathing symptoms, you can book an online appointment at a time that suits you. Our GMC-registered GPs offer same-day or next-day video and telephone consultations.
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Reviewed by Dr Zamiel Hussain, GP · GMC number 7486123 (check the GMC register) · About Dr Hussain
Updated: 7 November 2026