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How to Avoid an Asthma Inhaler-Induced Sore Throat

Do you experience a sore throat or hoarseness regularly, especially after using your asthma inhaler? Apparently quite a few of our readers do because we were recently asked to do an article about just that topic.

Inhaled steroids are considered to be the most effective long-term medication to control asthma.1 Sometimes called preventer medicines, inhaled steroids work non-stop to reduce inflammation and lessen the swelling in your airways. They help prevent asthma symptoms and attacks.2 However, they only keep working if you keep taking them as prescribed. For most people, this is one to two puffs once or twice every day.

The good news is, inhaled steroids are very safe to use. They’re nothing like the kind of steroids bodybuilders sometimes use to grow larger muscles. The bad news is, in some cases, they do have mild side effects, such as:3

  • Sore throat
  • Hoarseness
  • Cough
  • Fungal infections of the mouth and throat called thrush

Why might these side-effects occur?

There’s a simple reason why some people have the side effects of hoarseness, sore throat and so on that are listed above. It’s because the inhaled steroid isn’t fully inhaled. Instead, some of the medicine sits in the mouth and throat, causing irritation. Inhaled steroids aren’t designed to go into your mouth. They’re meant to be inhaled directly into your lungs, where they can go to work.4

But incorrect inhaler technique or lack of attention to aftercare following the use of your inhaler can lead to these side effects.

What can you do to avoid these side-effects?

It’s not hard to prevent these side effects, which is great news! Here are a few tips that can help.

1. Learn the proper way to use your inhaler.

Seems easy enough, right? Just stick the little plastic thingie in your mouth, squeeze and breathe in. What could go wrong? Well, actually, there are quite a few places where you could go wrong. And the result could be not only that you end up with hoarseness, etc., but you might also not be getting your full correct dose. And that can mean less asthma control than expected.

Here are the proper steps for using a metered-dose type inhaler without a spacer:5

  1. First, take the cap off the end of your inhaler and look inside to make sure everything looks clean. If it’s not, rinse it with warm water.
  2. Next, shake the inhaler vigorously about 10 to 15 times.
  3. Then, take a deep breath in and out, while holding the inhaler canister upright in front of you (not using it yet).
  4. Next, insert the inhaler mouthpiece into your mouth above your tongue and between your teeth, sealing your lips around it.
  5. Begin to breathe in slowly and deeply while pressing down on the canister one time.  Breathe in as deeply as you can.
  6. Hold your breath for 5 to 10 seconds if you can.
  7. Then, open your mouth and breathe out slowly.

If any of these steps don’t make sense to you, you can watch how-to videos at this page from the Centers for Disease Control (CDC). You may also want to ask a professional on your health care team to observe your technique and offer pointers on how you can improve. NOTE: If you use a dry powder type inhaler, the technique is not as important and side effects are less likely, but you can still think about asking someone to observe your use of the device.

2. Ask your doctor about using a spacer.

Some people, especially children, may benefit from using an extra device called a spacer. Or, if you’ve been unable to master the technique listed above, you may want to consider using a spacer. A spacer is a hollow tube that attaches to your inhaler’s mouthpiece. It slows the delivery of the steroid from your pressurized inhaler. It also helps to “aim” the medicine directly into your lungs, rather than your mouth.6 In short, spacers make it easier to coordinate breathing in and activating your inhaler.

The CDC site mentioned above also offers a how-to video and step-by-step directions on how to use a spacer with your metered dose inhaler. And again, your health care team should be able to support you in learning to use a spacer as well.

3. Practice healthy mouth-care after you inhale.

The final method of preventing side effects from your inhaler use is to practice healthy mouth care afterward. This entails4:

  • Rinsing your mouth and spitting out right after you put your inhaler away
  • Brushing your teeth

That’s it! If you continue to notice hoarseness, cough, or irritation in the mouth and throat after following all of these steps, then it’s time to talk with your health care team to get more personalized advice.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Asthma.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. https://www.nhlbi.nih.gov/files/docs/guidelines/asthma_qrg.pdf
  2. https://asthma.ca/get-help/asthma-3/treatment/inhaled-steroids/
  3. https://www.nhs.uk/conditions/steroid-inhalers/
  4. https://www.asthma.org.uk/advice/inhalers-medicines-treatments/inhalers-and-spacers/preventer/
  5. https://www.cdc.gov/asthma/pdfs/Inhaler_in_Mouth_FactSheet.pdf
  6. https://asthma.ca/spacers

Comments

  • BBdgh
    7 months ago

    The trick is follow up mouth care when you are out and about. Is there a process to follow then?

  • Kathi MacNaughton author
    7 months ago

    You might not be able to brush your teeth when out and about, but hopefully you could make your way to a rest room and rinse your mouth at least? That would be my suggestion; thanks for asking!

  • Leon Lebowitz, RRT moderator
    7 months ago

    Hi BBdgh and thanks for your inquiry. Kathi’s suggestion of a bathroom is ‘spot on’, when one is available. Some people always have a bottle of water with them (for hydration). If you can manage to have a bottle of water with you, you can swish, gargle, and rinse using that water. What do you think? Leon (site moderator)

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