A properly cared for inhaler results in more consistent and effective treatment for children with asthma.
You can maximize the use of your child’s asthma inhalers—and make sure he or she is getting the proper amount of medicine—by priming and cleaning them regularly.
Priming (releasing one or more sprays into the air) ensures your child gets an accurate dose of medication. Regular cleaning is also important to keep inhalers working properly, since residue can accumulate around the exit hole, impeding or even blocking the spray completely.
Start with a shake
Before using a new inhaler, shake it really well, three to four times. This mixes the ingredients in the canister so each dose contains the right blend of medication and propellant.
You also should shake the inhaler if it hasn’t been used in a while. Medications may have separated from the other ingredients in the canister and the metering chamber.
Prime your asthma inhaler
A new inhaler or one that hasn’t been used in a while may not deliver the correct amount of medicine with the first puff, so it needs to be primed.
To prime an inhaler, spray some “waste” puffs into the air after shaking (away from the face, of course). This will help make sure your dose contains the labeled amount of medication.
Our pediatric patients use a combination of controller and reliever inhalers. Following is a list of the most common asthma medications for both types of inhalers and the appropriate number of waste puffs for each one.
Priming guidelines for reliever metered dose inhalers (MDIs)
- Proair® Prime with 3 waste puffs
if new or not used in 2 weeks - Proair® Prime with 4 waste puffs
if new or not used in 2 weeks - Ventolin® Prime with 4 waste puffs
if new or not used in 2 weeks - Xopenex® Prime with 4 waste puffs
if new or not used in 3 days - Atrovent® Prime with 2 waste puffs
if new or not used in 3 days
Cleaning guidelines
Clean every week. Here’s how:
- Remove the cap.
- Removed the canister with reliever medicine
- Rinse the top and bottom of the colored case under warm, running water for 30 seconds.
- Shake off the excess water.
- Air-dry overnight.
Priming guidelines for controller MDIs
- Advair®
4 waste puffs if new
2 waste puffs if not used in 2 weeks - Flovent®
4 waste puffs if new
1 waste puff if not used in 2 weeks - QVAR®
2 waste puffs if new
2 waste puffs if not used in 10 days - Symbicort®
2 waste puffs if new
2 waste puffs if not used in 7 days
Cleaning guidelines
Advair or Flovent: Clean every week. Here’s how:
- Remove the cap.
- Leave the canister in the actuator.
- Use a cotton swab to clean inside where the medicine comes out.
- Wipe the inside of the mouthpiece with a clean, DAMP cloth.
- Air-dry overnight.
QVAR or Symbicort: Clean every week. Here’s how:
- Wipe mouthpiece with clean, DRY cloth.
- Do NOT wash or put in water.
Questions about inhalers? Call a PHS asthma educator at 651-642-1825 and ask for Asthma.
Before using a new inhaler, or if you have concerns about a used one, be sure to check the priming instructions—even if you have a child with asthma and have been using inhalers for years. Each one comes with its own set of recommendations. And if you have any questions, be sure to contact a PHS asthma educator.
Does your child have asthma or use inhalers? What experiences have you had with inhalers? Any tips or advice to share? We’d love to hear from you.
Kay Kufahl, RRT-NPS, LRT, AE-C, is Managing Director of In-Home Asthma Management Service at PHS. She has been with PHS since the doors opened in 1990.
