Key takeaways:
It’s common to use more than one inhaler, such as a rescue inhaler for quick relief and a maintenance inhaler for daily symptom management.
You can use two or more inhalers at the same time, but it’s best to wait about 1 minute between using each inhaler. You should also wait about 1 minute between puffs of your rescue inhaler. And always exhale fully before each inhalation.
Know which inhaler is for quick, as-needed relief and which is for daily use. Keep your inhalers clean, and track your doses so you never run out when you need quick relief.
Pharmacists get a lot of questions about inhalers. One of the most common is: Can you take two different inhalers at the same time?
The short answer is yes — using more than one inhaler is often necessary for treating lung conditions such as asthma and chronic obstructive pulmonary disease (COPD). But timing and technique matter to ensure your inhalers work as well as possible. Below, we’ll cover seven pharmacist-backed tips to help you use your inhalers safely and effectively.
1. When using multiple inhalers, it’s best to wait a minute between doses
Many people use more than one inhaler. For example, an asthma treatment plan commonly includes two inhalers: a fast-acting rescue inhaler to be used as needed and a long-acting maintenance inhaler to be used on a daily basis. Maintenance inhalers help manage symptoms and prevent asthma attacks.
In some cases, you may even use 3 or more different inhalers. For example, a COPD treatment regimen may include:
A rescue inhaler as needed
A daily combination maintenance inhaler, such as Advair (fluticasone / salmeterol)
A daily short- or long-acting inhaler for breathlessness, such as Spiriva (tiotropium)
It’s fine to use multiple inhalers at the same time. But it’s best to wait about a minute between each inhalation. This helps your body absorb the medication better from each puff. Your healthcare team may suggest a specific order or schedule for your inhalers based on your specific needs. That being said, if you need your rescue inhaler, don’t wait to use it. In that case, it’s fine to inhale a dose right away, even if you’ve recently used a different type of inhaler.
2. Breathe out before you inhale, then inhale deeply
There are three main types of inhalers: metered-dose inhalers (MDIs), dry powder inhalers (DPIs), and soft mist inhalers (SMIs). The steps for using your inhaler can vary depending on which type you have. But there’s one step that remains the same: Exhale fully before you inhale your dose.
Blowing all of the air out of your lungs helps you pull the medication deeper into your lungs when you inhale. This helps deliver the medication to your airways, where it’s needed. Just be sure to avoid exhaling into your inhaler device. This could add unwanted moisture or damage the inhaler. You should exhale before placing your mouth on the inhaler.
If you have questions about how to use your inhaler(s), don’t hesitate to ask your prescriber or pharmacist for guidance.
How to use a rescue inhaler: Review these step-by-step instructions to ensure you’re using your rescue inhaler correctly.
Asthma inhaler guide: Learn about the different types of asthma inhalers and how they work.
Cleaning your inhalers: Here’s why cleaning your inhalers regularly is important and how to do it properly.
3. Wait between puffs of your rescue inhaler
It’s common for rescue inhaler directions to say “use 1 to 2 puffs as needed.” But many people misunderstand this to mean that they should activate their inhaler twice in a row during 1 inhaled breath.
This mistake makes sense on the surface. If you’re having trouble breathing, you want relief as fast as possible — and 2 puffs seem better than 1. But your lungs can only absorb a certain amount of medication at a time. With most rescue inhalers, it’s best to wait at least 1 minute between puffs. This pause gives the first puff time to be absorbed into your lungs so it can start working. So waiting between puffs can actually help your rescue inhaler work better than trying to inhale 2 puffs at one time.
4. Understand the difference between your rescue inhaler and your maintenance inhaler
Rescue and maintenance inhalers both play a role in managing breathing symptoms. But it’s important to understand the difference between them.
Rescue inhalers, such as albuterol (ProAir, Ventolin HFA) and Airsupra (albuterol / budesonide), work quickly to open your airways when you’re wheezing or short of breath. You’ll typically only use them as needed for fast relief or to prevent symptoms before exercise.
Maintenance inhalers are your daily “controller” medications. They help reduce airway inflammation and prevent flare-ups over time. Examples include inhaled corticosteroids, such as fluticasone (Flovent) and combination inhalers such as Advair.
To avoid confusing your inhalers, it’s helpful to label them clearly as “daily” and “as needed.” You may also want to store them in different places. For example, keep your rescue inhaler in your pocket or purse and your maintenance inhaler on your kitchen counter or bedside table.
5. Use a spacer if you have trouble timing your breath with your inhaler
If timing your breath with your MDI inhaler dose feels tricky, a spacer (also called a holding chamber) can make it easier. A spacer is a plastic tube that attaches to your MDI inhaler. You’ll activate the inhaler, and the spacer holds the puff inside, giving you a few extra seconds to breathe it in.
Spacers can be especially helpful for:
Children
Older adults
People with limited hand strength or coordination
Talk to your prescriber if you think a spacer might be a helpful option for you or your child.
Good to know: DPIs and SMIs are designed to be easier to use — they don’t require the same level of breathing coordination as MDI inhalers. So spacers aren’t needed or effective with these types of inhalers.
6. Clean your inhaler regularly
A dirty inhaler can clog, deliver less medication, or even harbor bacteria. Keeping your inhaler(s) clean helps ensure that you get your full dose every time.
For detailed cleaning instructions, check the guide that comes with your inhaler. Here are a few do’s and don’ts to keep in mind.
Do:
Clean your MDI inhaler once a week.
Remove the canister (if your device allows) before rinsing.
Rinse the mouthpiece under warm running water for about 30 seconds.
Shake off extra water and let the inhaler air-dry completely before reassembling.
Store your inhaler with the cap on.
Don’t:
Use water on a DPI or SMI – just wipe the mouthpiece regularly.
Put the medication canister of your MDI in water.
Use an inhaler that’s gone through the washing machine (a good reason to always check your pockets before doing laundry).
7. Track your doses
Keeping track of your inhaler doses helps ensure that you don’t run out of medication when you need it. Many inhalers have built-in dose counters, but they aren’t always accurate.
Tracking your inhaler doses can also help you notice if you’re missing doses or using your rescue inhaler more often than usual. And it can help prevent you from throwing away an inhaler that still has plenty of doses left.
Here are a few easy ways to stay on top of your inhaler doses:
Mark each use on your calendar or in a medication-tracking app.
Refill your inhaler when you have about 20 doses left, or according to the instructions for your specific device.
Check expiration dates regularly and replace inhalers that are nearing expiration or expired.
Try a smart inhaler attachment. These digital sensors can track your use and notify you of a missed dose, and they may help you use your inhaler more effectively.
Frequently asked questions
The “rule of two” means needing your rescue inhaler less than twice a week during the day, less than twice a month at night, and having no limits on physical activity. If you’re using your rescue inhaler more often than this, it’s a good sign that you need an adjustment to your asthma treatment plan.
Rescue inhalers (such as albuterol) work quickly to open your airways during a flare-up or asthma attack. Maintenance inhalers (such as inhaled corticosteroids and long-acting bronchodilators) are used daily to reduce inflammation and prevent symptoms from returning.
The “rule of two” means needing your rescue inhaler less than twice a week during the day, less than twice a month at night, and having no limits on physical activity. If you’re using your rescue inhaler more often than this, it’s a good sign that you need an adjustment to your asthma treatment plan.
Rescue inhalers (such as albuterol) work quickly to open your airways during a flare-up or asthma attack. Maintenance inhalers (such as inhaled corticosteroids and long-acting bronchodilators) are used daily to reduce inflammation and prevent symptoms from returning.
The bottom line
Using more than one inhaler is often necessary for managing conditions such as asthma and chronic obstructive pulmonary disorder (COPD). But getting the timing and technique right can make a big difference in how well your medications work.
Start by focusing on proper technique: Breathe out fully before each puff, and inhale deeply. Wait about a minute between puffs of your rescue inhaler and when switching from one inhaler to another. Know which inhaler is for quick relief and which is for daily use. Keep your inhaler clean, and track your doses so you never run out when you need quick relief.
If you’re unsure about how or when to use your inhalers, ask your pharmacist or prescriber to walk you through the steps. Some people may also benefit from using a spacer. Small adjustments can make a big difference in how well you breathe and how much benefit you get from your inhaler treatment regimen.
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References
American College of Allergy, Asthma & Immunology. (2022). What is the "rule of twos" for asthma? [video]. YouTube.
Anderson, W. C., III, et al. (2019). Screening for inhalation technique errors with electronic medication monitors. The Journal of Allergy and Clinical Immunology: In Practice.
Conner, J. B., et al. (2013). Improving asthma management: The case for mandatory inclusion of dose counters on all rescue bronchodilators. Journal of Asthma.
ConsumerMedSafety.org. (2024). Don’t confuse “rescue” and “maintenance” inhalers.
Levy, M. L., et al. (2016). Inhaler technique: Facts and fantasies. A view from the Aerosol Drug Management Improvement Team (ADMIT). Primary Care Respiratory Medicine.
MedlinePlus. (2024). How to use an inhaler - with spacer.
National Heart, Lung, and Blood Institute. (2021). How to Use a Metered-Dose Inhaler Fact Sheet. National Institutes of Health.
ScienceDirect. (n.d.). Soft mist inhaler.
U.S. Department of Veterans Affairs. (n.d.). Caring for your metered-dose inhaler.
Vytrisalova, M., et al. (2019). Breathing out completely before inhalation: The most problematic step in application technique in patients with non-mild chronic obstructive pulmonary disease. Frontiers in Pharmacology.
