Metered-Dose Inhalers (MDI): How to Use

The metered-dose inhaler (MDI) is a pressurized canister of medicine that releases a medicated mist. Your child inhales the mist into the airways of his lungs. The MDI can be used alone, but it is highly recommended that your child use a spacer or valved holding device attached to the MDI.

Several different types of medicines are available as MDIs, including:

• bronchodilators (Proventil, Ventolin, Maxair, or Alupent)
• inhaled steroids (Azmacort or Flovent)
• cromolyn (Intal)
• nedocromil (Tilade)
• ipratropium bromide (Atrovent).

When a child is using more than one type of MDI, he will usually use the bronchodilator first.

There are several ways to use an MDI. If your child is not using a spacer or valved holding device, the technique most often recommended is as follows:

1. Shake the MDI vigorously.
2. Hold the MDI upright so the mouthpiece is at the bottom.
3. Hold the mouthpiece 1-and-1/2 to 2 inches in front of an open mouth (about 2 to 3 finger widths).
4. Breathe out normally.
5. Press the MDI down once so it releases a spray of medicine into the mouth while your child breathes in slowly. (One spray is often called a puff.)
6. Continue breathing in as slowly and deeply as possible.
7. Hold the breath for 10 seconds or as long as is comfortable (this gives the medicine time to reach the airways).
8. Breathe out slowly.
9. After taking a few normal breaths, repeat steps 1 through 8 for another inhalation (puff) if required. Take the number of puffs prescribed by your doctor.