How to Use a Metered Dose Inhaler (MDI) with Spacer

Dr Balachandra BV 18 September 2025

Watch my step-by-step video here for a clear demonstration: How to use MDI with Spacer – Dr Balachandra BV

Step-by-Step Guide to Using an MDI with Spacer

Prepare the Spacer and Inhaler

Usually, the spacer comes in two parts that need to be joined and locked securely.
Open the mouthpiece cover and attach the MDI inhaler to the spacer firmly.
Shake the inhaler vigorously 4 to 5 times before each use.
If it is the first time using the inhaler, release 2-3 test sprays into the air to prime it.

Inhale the Medicine

Press the inhaler canister once to release the medicine.
Breathe in slowly and deeply through your mouth for about 4 to 5 seconds.
Remove the spacer from your mouth and hold your breath for at least 10 seconds (if possible, up to 20 seconds).
if patient is unable to hold breath for more than 10 seconds then do slow normal breathing for 5 to 6 times without removing spacer
Exhale slowly through your nose.
Repeat if Needed
If your doctor prescribes two doses, shake the inhaler again before the second puff and repeat the process.
Care and Maintenance
Wash the spacer once a week in regular (not hot) water with mild soap; air dry thoroughly.
Do not wipe the spacer with cloths.
Replace your spacer every six months to maintain medication delivery efficiency.
After using your inhaler with a spacer, drink water and gargle to reduce any medication residue in your throat.

Conclusion
Correct use of an MDI with a spacer ensures better delivery of medicine, improved symptom control, and fewer side effects. Practice the steps regularly and consult your doctor if you experience any difficulty.
References:
Dr Balachandra BV, Allergy Central (Video)
https://www.youtube.com/watch?v=7MQK_2tPItc