Using spacers with asthma or COPD inhalers

For most, COPD or asthma inhalers are simple to use and convenient to carry. But for some, particularly children and the elderly, pressing and coordinating breathing with a metered-dose inhaler proves challenging. With inadequate technique, medicine lands in the mouth or back of the throat and not the lungs, where it can start acting. A spacer can bridge this gap, as medicine is delivered to the chamber and slow steady breaths allow it to easily reach the lungs.

Spacers also reduce side effects of poor inhaler technique, as medicine – usually the steroid inhalers – does not build up in the mouth or throat, reducing the risk of oral thrush and other complications.

Spacers can be used with your reliever inhaler (salbutamol), for when symptoms come on, or your preventer inhaler, to reduce inflammation in the long term. They come with or without a detachable mask, and they’re available in different sizes, according to a child’s age.

It's important to ensure that the spacer is suitable for the inhaler you are using, as there's no universal fitting for spacers or inhaler brands, so it may not be suitable. Your prescribing doctor or nurse or your pharmacist should be able to help, and you can also check the product information for compatibility.

Always use according to instructions from your doctor, nurse or other healthcare professional.

• Shake your inhaler before use to ensure the correct mix of drug and propellant gas before use.

• Insert the inhaler mouthpiece into the universal fitting, ensuring a snug, airtight fit.

• Use the inhaler and spacer device while standing or seated, looking straight ahead.

• Holding the spacer device in one or both hands, seal your lips around the mouthpiece and hold between your teeth. The mask should fit snugly around the nose and mouth.

• Spray one dose of the inhaler into the spacer chamber, and breath gently and deeply for four to five breaths or 30 seconds, then remove the spacer from the mouth and assess your breathing.

• Repeat a second dose if necessary, waiting at least 30 seconds.

• Avoid pressing two doses of a metered-dose inhaler immediately one after the other, since the inhaler device is designed to give a measured dose of drug powder suspended in propellant gas, so you should shake before using in between, to avoid just pumping propellant gas with less drug powder.

You should clean the spacer at least once a week. Do not clean with boiling or hot water as this may damage it. Make sure you remove any mask and the base and wash all components in soapy water, then rinse in clear water.

Let the components air-dry in a vertical position. Don't wipe or dry them with a cloth, as this can cause static to build up in the chamber, allowing medicine to cling to the chamber walls rather than being inhaled.

Do check your spacer regularly and replace if it becomes cracked, opaque or scratched on the inside. For hygiene reasons, keep your spacer solely for your own use and don’t share.