Is a Spacer Right for Your Inhaler? Here’s How to Use One

If you or your child has asthma, chances are you rely on inhalers to manage your symptoms. The same is true if you have chronic obstructive pulmonary disease (COPD). 

Inhalers are small, handheld devices that deliver medicine into the lungs. The medication works best — and fastest — when it’s inhaled straight into the lungs. And this helps prevent side effects, too. But most people who use inhalers don’t use them properly, and most of the medicine doesn’t actually reach the lungs. That’s where a spacer can help. 

What is an inhaler spacer?

A spacer is a clear plastic chamber or cylinder with a mouthpiece or mask. It’s meant to be used with HFA (hydrofluoroalkane) inhalers — also known as metered-dose inhalers. 

HFA inhalers contain medication in a liquid form. 

The liquid medication is propelled out of the inhaler as a gas — a bit like a spray can. Sometimes the medication can end up landing in your mouth and throat. But using a spacer with these inhalers lets you inhale more of the medication into your lungs. In other words, the spacer helps the medication do a good job.

How do you use a spacer with an inhaler?

Using an inhaler with a spacer is easy. 

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The inhaler fits into one end of the spacer. At the other end, there’s a one-way valve between the spacer chamber and the mouthpiece. Once you spray the medication into the chamber, it stays there until you breathe it all in through the mouthpiece or mask. 

If you’re new to this, follow these steps:

1. Shake your HFA inhaler well.

2. Remove the inhaler cap and connect it to the spacer. 

3. Put the spacer mouthpiece between your teeth, then seal your lips around the mouthpiece. If your spacer has a mask attached, put the mask on your (or your child’s) face, making sure there are no gaps.

4. Breathe out into the spacer.

5. Deliver a dose of your inhaler medication by pressing the button once. 

6. While keeping the spacer in place, breathe in and out slowly and deeply three to five times. 

7. Repeat steps 1 through 6 if your prescription calls for 2 puffs. 

After using your inhaler, rinse out your mouth with water and gargle. If your inhaler has a mask, wash your face too. This helps to prevent some side effects from the medication. 

Benefits of using an inhaler spacer 

Using a spacer is always the best way to use an HFA inhaler. That’s because it allows the most medication from each puff to get into the lungs — where it can act. 

Without a spacer, it can be hard to coordinate pressing the inhaler button with a slow deep inhale, all while sealing your lips around the inhaler. This can be especially tricky for children and older adults. 

Plus, you need to be able to hold your breath for 10 seconds so the medication can reach the lungs. This can be hard at the best of times, but especially if you’re feeling short of breath or you’re coughing. 

HFA inhalers are small and practical, so it might be tempting to avoid using a spacer. But using a spacer with your inhaler improves the chances that you use it correctly. Here’s why a spacer helps:

• The medication has a better chance of reaching the lungs, which is where it will bring you relief.

• Without a spacer, the inhaler medication may coat the mouth and tongue instead of getting into the lungs. This can cause side effects like a hoarse voice or oral thrush, especially with steroid inhalers.

Inhaler spacer troubleshooting

If you’re not feeling any benefit from your inhaler, even with a spacer chamber, ask your provider to watch you use it. They can make sure you’re using it correctly and that enough medication is getting into your lungs. 

If your inhaler isn’t working well, here are some things you can try: 

• Try using a spacer with a mask if you’re struggling to make a complete seal with your mouth around the spacer mouthpiece.

• Be sure to shake the inhaler before use and between puffs. 

• Don’t wait too long to inhale after pressing the inhaler. If you do, the medication will fall to the bottom of the spacer.

• Make sure you breathe in deeply enough.

• Check that you still have doses left on the inhaler.

• Make sure your inhaler isn’t expired.

Where to buy an inhaler spacer

Spacers are medical devices. So your healthcare provider can write a prescription for one. And you can pick it up from most pharmacies. You can also buy spacers online, with or without a prescription. They cost between $8 and $20 depending on the model and the supplier.

Tips to care for your spacer

Keeping your spacer clean will make sure it works at its best. Clean it before the first use and then every month. Wash it in warm water with dish soap and let it air dry. Let it dry completely before you use it, as it won’t work correctly if it’s still wet. 

Every 6 to 12 months, you can ask a doctor, nurse, or pharmacist to check that your spacer is working well. Most of the time, a spacer should be replaced at least once a year. 

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Written by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

Reviewed by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

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