The basic steps for using a rescue inhaler

A rescue inhaler works only if the medicine reaches your lungs. Most people use theirs wrong the first time, which means the medicine stays in your mouth or throat instead. The steps are simple once you know them, but the order and timing matter.

First, shake the inhaler firmly for 10 to 15 seconds. Hold it upright with your thumb on the base. Breathe out completely—empty your lungs as much as you can. Place the mouthpiece between your teeth and close your lips around it, or hold it about an inch from your open mouth. Press down on the top of the inhaler once while you breathe in slowly and deeply through your mouth. Keep breathing in for 3 to 5 seconds after you press, then hold your breath for 10 seconds if you can. Breathe out slowly.

If you need a second dose, wait at least one minute, then repeat the whole sequence. Many people skip the waiting period and press twice in a row, which wastes the second dose.

Key Takeaways

  • Shake the inhaler for 10 to 15 seconds before each use, because the medicine settles at the bottom.
  • Breathe out completely first, then press and breathe in at the same time—pressing before you inhale means the medicine goes nowhere.
  • Hold your breath for 10 seconds after inhaling so the medicine can reach deep into your lungs instead of staying in your airways.
  • Wait at least one minute between doses if you need more than one puff, and use a spacer if you have trouble coordinating the press and breath.

When to use a rescue inhaler versus a daily controller

Rescue inhalers (usually blue) work fast but only for a few hours. They are for moments when you are wheezing, short of breath, or having an asthma attack. Controller inhalers (usually orange, brown, or red) contain steroids and work slowly over days and weeks to prevent attacks from happening in the first place. They do not help during an attack.

If you are reaching for your rescue inhaler more than twice a week, that is a sign your asthma is not controlled and you may need a controller inhaler or a change in your current one. Tell your doctor how often you use your rescue inhaler at your next visit. Using it more than twice weekly means your daily treatment is not working well enough.

Using a spacer to make inhalers work better

A spacer is a plastic tube that attaches to your inhaler. It holds the medicine in a chamber for a fraction of a second longer, giving you time to breathe it in without perfect timing. Spacers work especially well for children, older adults, and anyone who has trouble coordinating the press-and-breathe motion.

To use a spacer, attach it to your inhaler, shake the whole thing, breathe out, place the mouthpiece in your mouth, press the inhaler once, then take 5 to 6 slow, deep breaths through the spacer. You do not have to press and breathe at exactly the same moment. Spacers cost $10 to $30 and are available at any pharmacy without a prescription. If you struggle with your inhaler, ask your doctor or pharmacist whether a spacer would help you.

What to do if your inhaler does not seem to work

If your rescue inhaler is not relieving your symptoms after 15 minutes, or if you need it more than every four hours, you are having a serious asthma attack and need emergency care. Call 911 or go to an emergency room. Do not wait to see if it gets better on its own.

If your inhaler seems less effective than it used to be, the problem is usually one of three things: you are not using the right technique, the inhaler is empty or expired, or your asthma has gotten worse. Check the expiration date on your inhaler. Practice your technique in front of a mirror or ask your pharmacist to watch you use it. If both of those are fine, tell your doctor—your asthma may need stronger treatment.

Keeping your inhaler clean and ready

After each use, wipe the mouthpiece with a dry cloth. Once a week, rinse the plastic casing (not the metal canister inside) under warm water and let it air dry completely before putting the canister back in. A wet inhaler will not work properly.

Keep track of how many doses you have left. Most inhalers contain 200 doses, but there is no reliable way to count them as you use them. One method is to write the date you opened it on the inhaler with a marker, then refill it about a month before you think it will run out. Ask your pharmacy to check the dose counter if your inhaler has one—many newer models display the number of doses remaining.

Store your inhaler at room temperature, away from heat and cold. Do not leave it in a hot car or a freezer. Keep a backup inhaler at home and carry one with you if you leave the house for more than a few hours.

Differences between rescue and controller inhalers

Rescue inhalers contain albuterol (also called salbutamol), which opens your airways within minutes. You feel the effect quickly. Controller inhalers contain inhaled steroids like fluticasone or budesonide, which reduce swelling in your airways over time. You will not feel them working, and they do not help during an attack.

Some people use a rescue inhaler every day because they do not have a controller, or because their controller is not strong enough. This is not safe long-term. Rescue inhalers can cause side effects like tremor and rapid heartbeat if used too often. If you are using your rescue inhaler daily, your doctor needs to know so they can adjust your controller treatment.

A few inhalers combine a fast-acting rescue medicine with a controller steroid in one device. Your doctor will tell you if this type is right for you and how to use it.

Common mistakes that reduce how well inhalers work

The most common mistake is not shaking the inhaler. The medicine is a powder or liquid that settles at the bottom. If you do not shake it, you get mostly air on the first few puffs and mostly medicine on the last few. Shake for 10 to 15 seconds every single time.

The second mistake is breathing in too fast. If you suck in hard and quick, the medicine hits the back of your throat instead of traveling deep into your lungs. Breathe in slowly and steadily, as if you are smelling a flower. The whole breath should take 3 to 5 seconds.

The third mistake is not holding your breath after inhaling. The medicine needs time to settle in your lungs. Hold your breath for 10 seconds—or as long as you comfortably can—before breathing out. If you breathe out immediately, the medicine leaves your lungs before it can work.

A fourth mistake is using the inhaler in your mouth instead of at your lips. If the mouthpiece is deep in your mouth, you are more likely to swallow the medicine. Hold it about an inch away from your open mouth, or between your teeth with your lips sealed around it. Both methods work; pick whichever feels more natural.

Frequently Asked Questions

Can I use someone else's inhaler if I am having trouble breathing?

No. Inhalers are prescribed for one person based on their specific asthma. Using someone else's could be dangerous if the dose is wrong for you, and it leaves them without their own medicine. If you do not have an inhaler and are short of breath, call 911 or go to an emergency room.

How do I know if my inhaler is empty?

The most reliable way is to look at the dose counter on the inhaler if it has one—it will show zero. If there is no counter, place the metal canister in a glass of water. If it sinks, there is still medicine inside. If it floats, it is empty. You can also ask your pharmacist to check it for you.

What if I cough right after using my inhaler?

Coughing is common and usually means the medicine reached your airways. It will pass in a few seconds. If you cough so hard that you cannot hold your breath for 10 seconds, wait a minute and try again. Rinsing your mouth with water after using your inhaler can reduce coughing.

Do I need to use my rescue inhaler before exercise?

Only if your doctor told you to. Some people with exercise-induced asthma use their rescue inhaler 15 minutes before activity to prevent symptoms. Others do not need it at all. Ask your doctor whether you should use it before exercise and when to use it.

Can I use my inhaler while wearing a mask?

Yes. Lift the mask slightly to place the mouthpiece in your mouth or hold it an inch from your lips, use the inhaler, then replace the mask. The medicine still reaches your lungs. You do not need to remove the mask completely.