How to Use a pMDI Inhaler and Spacer | KiwiMeds Device Guide
💨 How to Use a pMDI (Pressurised Metered Dose Inhaler) with a Spacer
Used for: Salbutamol (Ventolin), Beclomethasone, Fluticasone/Salmeterol combinations, and other pressurised inhalers
What is a pMDI?
A pressurised metered dose inhaler (pMDI) is a small aerosol canister inside a plastic case that delivers a measured dose of medication as a fine spray. Common examples in New Zealand include Ventolin (salbutamol) for relieving asthma and COPD symptoms. Using a spacer device with your pMDI is strongly recommended — it makes the inhaler much more effective and easier to use.
What You Need
- Your pMDI inhaler (e.g. Ventolin)
- A spacer device (e.g. Volumatic, Able Spacer, or Breath-a-Tech)
- Clean hands
Step-by-Step: Using a pMDI with a Spacer
- 1Remove the cap from your inhaler and spacer. Check the mouthpiece for any dust or objects.
- 2Shake the inhaler well for 5 seconds, then insert the inhaler into the back of the spacer.
- 3Breathe out gently — exhale away from the spacer to empty your lungs.
- 4Place the spacer mouthpiece in your mouth, sealing your lips around it.
- 5Press the inhaler once to release one puff into the spacer.
- 6Breathe in slowly and deeply through your mouth — breathe in as much air as you can. If you hear the spacer whistle, you are breathing too fast — slow down.
- 7Hold your breath for 5–10 seconds, then breathe out slowly through your nose.
- 8Wait 30–60 seconds before taking a second puff (if prescribed). Shake the inhaler again before each puff.
- 9Replace the caps on both the inhaler and spacer after use.
- 10If your inhaler contains a steroid (preventer) medication, rinse your mouth and gargle with water after use — do not swallow. This prevents oral thrush.
Using a pMDI Without a Spacer (not recommended but shown for reference)
If you do not have a spacer available, you can use the inhaler directly, but less medication reaches the lungs. Shake the inhaler, breathe out, place the mouthpiece just past your teeth with lips sealed, press and breathe in slowly at the same time, hold for 10 seconds. Ask your pharmacist for a spacer as soon as possible.
Caring for Your Spacer
- Wash weekly: Separate the spacer parts and wash in warm soapy water. Do NOT rinse — leave the detergent on. Allow to air dry (do not towel dry — static builds up and reduces effectiveness).
- Replace every 6–12 months or sooner if cracked or discoloured.
- One spacer per person — do not share spacers.
- Prime a new spacer by firing 5 puffs of your inhaler into it before first use.
How to Check How Much is Left
Most modern pMDIs have a dose counter. If yours does not, you can float it in water — but this is not reliable for all inhalers. The best method is to count your doses. Ask your pharmacist how many doses your inhaler contains when dispensed.
Common Mistakes to Avoid
Always press and breathe at the same time (or use a spacer).
Slow, steady inhalation gets more medicine to your lungs.
The medicine and propellant can separate.
This causes oral thrush — always rinse and gargle.
Spacers are available at all NZ pharmacies. Some spacers are funded by Pharmac with a prescription — ask your pharmacist or doctor. Common funded spacers include the Able Spacer and Breath-a-Tech. Children’s spacers with a mask attachment are also available for young children and babies.
This information is for educational purposes only and is not a substitute for personalised advice from your doctor or pharmacist. Always seek professional guidance before making changes to your medications.
• Asthma + Respiratory Foundation NZ — Resources & Fact Sheets
• New Zealand Formulary (NZF)
• Medsafe NZ — Consumer Medicine Information