Australian Polyclinic · Patient technique guide

How to Use a Metered-Dose Inhaler Without a Spacer

This guide explains a conventional press-and-breathe pMDI used directly through its mouthpiece. A spacer is generally preferred, particularly when timing the spray with your breath is difficult. Follow the device and technique recommended by your clinician.

Have a spacer? Use our spacer technique guide.

Medically reviewed and approved by Dr G Sarwar Chaudhry, MBBS, FRACP (Australia), FCCP (USA) — Consultant Pulmonologist and Sleep Physician.
Last reviewed: October 28, 2026.

Check your device first

These steps do not describe dry-powder, soft-mist or breath-actuated devices. Ask your pharmacist to identify your inhaler if you are unsure.

Check the expiry date and dose counter, if fitted. Read the product leaflet before first use: priming sprays, re-priming intervals, shaking and cleaning requirements vary. There is no single priming rule for every pMDI.

Step-by-step technique

  1. Remove the cap, check the mouthpiece is clear and prepare the inhaler according to its leaflet.
  2. Sit or stand upright. Hold the inhaler upright.
  3. Exhale comfortably away from the mouthpiece.
  4. Close your lips around the mouthpiece.
  5. Begin a slow inhalation and press the canister once as you start breathing in. Continue inhaling steadily and deeply.
  6. Remove the inhaler and hold your breath for up to 10 seconds, or as long as comfortable. Exhale gently.
  7. If another puff is prescribed, follow the product's waiting interval, shake again if required, and repeat.
  8. Replace the cap. After a steroid-containing inhaler, rinse your mouth and spit out the water.

When a spacer may help

Pressing too early or too late can make effective delivery harder. A compatible spacer reduces the coordination needed and reduces medicine deposited in the mouth and throat. Ask for a technique check if you struggle with the press-and-breathe sequence.

Priming, cleaning and knowing when to replace it

Keep the patient leaflet with your inhaler. Ask your pharmacist to mark the priming instructions and demonstrate the cleaning method for that exact product.

Use the dose counter where available. If there is no counter, ask how to track the labeled number of doses, including test sprays. Do not rely on a remaining spray or the sound of the canister to decide that medicine is still available.

Make your next review useful

Before the visit, note the names of your inhalers, the doses you actually take, any difficulty using them and when your symptoms occur. This gives your clinician a useful starting point for checking both the treatment and the device.

Common questions

Should I switch to using a spacer? Discuss a compatible spacer with your clinician, especially if coordination is difficult or you use a steroid-containing pMDI.

Can I increase the dose if it seems ineffective? Follow your prescription and action plan. Arrange a review rather than changing routine treatment yourself. If an attack does not improve with your prescribed reliever, seek emergency care.

Bring your inhaler to your appointment

Bring every inhaler you use, together with its packaging and spacer if you have one. At Australian Polyclinic in DHA Phase 5, Lahore, ask for a demonstration using your own device, then show the technique back to the clinician.

Explore our asthma guide or pulmonology services.

Ask about an appointment

References