Common Asthma Inhaler Errors and How To Fix Them

By Andrea M. Jensen CHES AE-C

Last Updated:

3 min read

I hear this A LOT - people say, "My asthma inhaler stopped working."

Well... I hate to say this, but inhalers don't just "stop working." The medicine doesn't change, but your body can, and the way you use your inhaler can make a difference in how you feel.

Asthma inhaler not working? Check your technique

My colleague teases me about "user error" when I have problems with my computer. We lovingly call her the computer whisperer, and she can fix anything. Whenever I have problems with my computer and call her for help, she easily fixes it right away (even though I've already tried) and teases me about user error. Guilty as charged.

I may not be skilled with computers, but I am with inhalers!

User error is very common with inhaler technique. In fact, did you know that 92 percent of people do NOT use their inhaler the right way?!¹

Yes, you read that right - 92 percent! Some people have said, "How hard is it? I've been using an inhaler for years - it can't be that hard!"

The problem is that there are numerous types of inhalers. There are metered-dose inhalers (MDIs), dry powder inhalers (DPIs), and soft mist inhalers.

Common issues with MDIs

Most common problems with metered-dose inhalers:²

Forgetting to shake the inhaler (gotta mix up the propellant and medicine!)
Not exhaling all the way BEFORE you press the inhaler (empty those lungs first - so you can breathe in deep and inhale all of the medicine from your inhaler!)
Forgetting to hold your breath to the count of 10 (or as long as you can)
Not rinsing your mouth if it's a controller inhaler

Did you know that controller inhalers (the kind you take every day) are made with a yeast base? That means you can develop a very annoying fungal infection (thrush) that is very difficult to get rid of. Seriously. Awful stuff.

Common issues with DPIs

Most common problems with dry powder inhalers:³

Thinking the inhaler needs a spacer (no need - there is no propellant!)
Blocking the vent with your lips or fingers (take a peek - they have cool vents on the top of the inhaler or near the mouthpiece)
Inhaling WAY too softly

Since dry powder inhalers do not contain a propellant, you become the propellant. I tell people the only way to get the powder out is to "suck like a milkshake" (hard and fast).

This is the opposite of metered-dose inhalers. Is it any wonder that people get confused and don't use their inhaler correctly?

Many people have both kinds of inhalers. Their controller inhaler may be a dry powder inhaler, and their rescue inhaler is a metered-dose inhaler. Therefore, they must use the opposite technique for each inhaler.

A brief review

To recap the differences between inhalers…

Metered-dose inhaler: breathe in slowly and steadily (and use a spacer).
Dry powder inhaler: breathe in hard and fast (and don't use a spacer).

We know how expensive inhalers are, right? I want to get my money's worth by using my inhaler correctly. Additionally, it works more effectively when you take in more medicine.

If you remember nothing else from this article, remember that inhalers don't just "stop working."

If you have watched the inhaler technique video and are using your inhaler the right way but are still having a hard time with your asthma, call your doctor! You may need a stronger inhaler or a different type of inhaler.

There is a rainbow of inhalers on the market. Ensure you find the right one for your body and use it correctly.

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CommunityMemberf6afa9 Member

 Andrea m JensenIve only read a little of this, but it is scandalous that such ignorance can be published and read by asthma sufferers. The brown inhaler is NOT made with a yeast base. What breathtaking stupidity. It’s a steroid. Nothing to do with yeast, it just produces an environment in which yeasts find it easy to grow. Spreading this kind of misinformation where other sufferers might take it on board as gospel is dangerous. I didn’t read the rest of it, I’m sure it’s full of absolute garbage and it should be deleted.
lauren.mullin Moderator

<inline-mention username="Andrea M. Jensen CHES AE-C" user-id="3001956"/> Great advice Andrea. I'm glad that this method has worked well for you in the past. Thanks for taking the time to share it! -Lauren (team member)
Leon Lebowitz, RRT Moderator & Contributor

Hi <inline-mention username="Aelfgifu1" user-id="8792927"/> - thanks so much for your post. It can be frustrating (to say the least), when one's inhaler stops working so early in it's active cycle, despite your best efforts. I understand that quite well. As, my good colleague, <inline-mention username="Andrea M. Jensen CHES AE-C" user-id="3001956"/> suggested, there is a better to use nowadays on the current generation of inhalers (with integral 'counters'). I have been cleaning mine the way Andrea suggested for some time now - I find it to be far superior over the 'old' rinsing with water technique. I am hopeful you will give it a try too, especially on the two inhalers that still have contents remaining. You may be able to save them. What do you think? All the best, Leon L (author/moderator <a href='https://asthma.net' target='_blank'>asthma.net</a>)
Andrea M. Jensen CHES AE-C Contributor

<inline-mention username="Aelfgifu1" user-id="8792927"/> I had this problem with my ProAir inhaler. I tried to clean the actuator with water (as I had done in the past), and it stopped working. My hunch is that when they finally added the counters to all of the inhalers, that somehow changed the actuator (the holder) and it seems like it doesn't work when it's cleaned with water. Since then, I clean my inhaler with a damp Q-tip. I'll use that to swab out the tiny hole where the medicine comes out, then use the dry end of the Q-tip to dry the hole. I use a bleach or antiseptic wipe on the mouthpiece. You can always look at the directions from the manufacturer of your particular inhaler, as they are all a little different. Good luck! Andrea M. Jensen, CHES, AE-C Certified Asthma Educator
Aelfgifu1 Member

My two Albuterol inhalers both stopped working after about 40 pumps. I have cleaned them multiple times. The cannisters are still mostly full. It has nothing to do with my technique. They simply aren't expelling anything. I've used inhalers for years and know what I'm doing. Beyond cleaning them with water in the sink and letting them dry completely, what can I do to get them working again? I've never had this problem before. Thank you.