COPD inhalers: types, how to use them, and choosing the right one

Most people with COPD use inhalers every day, but many still don’t get the full benefit because of technique or the wrong device. Get the basics here — what each inhaler does, simple how-to steps, and realistic tips for picking and managing the right one.

There are two main goals with inhalers: quick relief and long-term control. Quick relief inhalers (often called SABA like salbutamol or SAMA) open airways fast when you’re short of breath. Controller inhalers include LABA, LAMA, and inhaled steroids or combinations; these reduce flare-ups and keep breathing steadier over time. Nebulizers turn liquid medicine into a mist and can be helpful when you can’t use a handheld device.

How to use your inhaler the right way

MDI (metered dose inhaler) steps: shake the inhaler, breathe out fully, place the mouthpiece between your lips, start a slow steady inhale and press the canister once, keep inhaling slowly, then hold your breath for 5–10 seconds. If you can’t coordinate press-and-breathe, use a spacer — it makes timing easier and boosts delivery to the lungs.

DPI (dry powder inhaler) steps: don’t shake. Load the dose as instructed, exhale away from the device, seal your lips around the mouthpiece, take a quick deep breath to pull the powder into your lungs, then hold your breath for a few seconds. If you breathe too slowly, the medicine won’t reach deep airways.

Nebulizers: sit upright, breathe normally through the mouthpiece or mask until the cup runs out. They’re useful during severe flare-ups or when inhaler technique is too hard. Note: recent Ventolin nebules shortages mean clinics often suggest switching to an MDI plus spacer when appropriate.

Choosing and managing inhalers

Talk to your doctor about what you can actually use. Hand strength, coordination, and breath power matter. If you struggle with MDIs, a spacer or DPI might be better. If you use inhaled steroids, rinse your mouth after each dose to cut fungal risk.

Keep track of doses, store inhalers at room temperature, and clean mouthpieces weekly. Carry your rescue inhaler and a written action plan that shows when to step up treatment or call your clinician. If you need rescue doses more often than usual, you’re at higher risk for an exacerbation — call your provider.

For cost or supply problems, only use reputable pharmacies and check with your prescriber before switching brands. During shortages, clinics often substitute an MDI plus spacer or a different but equivalent inhaler. Emergency signs that need immediate care: severe shortness of breath, blue lips or face, confusion, or inability to speak in full sentences.

Small changes make a big difference: practice technique with your nurse, set phone reminders, and keep a spare inhaler. Used right, your inhalers can cut flare-ups and keep you moving.