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The Pros and Cons of Dry Powder Inhalers and How to Use Them Correctly

Medically reviewed by Philip Ngo, PharmD — By Emily Swaim on October 14, 2022Share on PinterestViktor Holm Images/Stocksy UnitedAn inhaler is a device that helps you breathe medication directly into your lungs. People typically use inhalers to treat asthma or chronic obstructive pulmonary disease (COPD). The three main types of inhalers include:Metered dose inhalers: These inhalers spray medication in a quick burst via the propellant hydrofluoroalkane (HFA). Examples include Proair HFA, Atrovent HFA, and Ventolin HFA.Soft mist inhalers: These inhalers release medication in a mist. Examples include Spiriva Respimat and Combivent Respimat.Dry powder inhalers (DPIs): These inhalers contain a dry powder that breaks apart into an aerosol when you breathe through the mouthpiece. Examples of DPIs include:Diskus (Advair, Flovent, and Serevent)Turbohaler or Turbuhaler (Symbicort)Pulmojet (Lifsar)Novolizer (Budelin and Ventolin HFA) Many people find DPIs the easiest kind to use. With a DPI, you don’t have to sync your breathing with any buttons or switches. You can simply open the device and inhale. As an added bonus, they’re also more environmentally friendly. Read on to learn how DPIs work and how to use yours correctly.

How they work

All DPIs work via the same basic mechanism. You open the device, put your mouth on the opening, and suck up the powdered medication inside. The force of your breath cracks the powder, which is chemically designed to dissolve into tiny, breathable particles. Some DPIs have spirals or ridges inside to help break up the powder further. The pieces need to be small so they’ll make it to your lungs — larger chunks may stick to the walls of your mouth and throat. DPIs can administer two different types of medication: bronchodilators and corticosteroids. Bronchodilators relax the muscles in your throat, opening them up so you can breathe more easily. Corticosteroids help reduce swelling and mucus production inside your airways. The specific medication you take will depend on your age and condition and the severity of your symptoms.

How to use a dry powder inhaler

While most people find DPIs very simple to use, you might skip essential steps if you don’t realize their importance. Using your inhaler incorrectly may prevent you from getting the full amount of medication you need, which can have serious health consequences. One 2016 study had people try three types of DPIs. Although some brands were more error-prone than others, training made a huge difference for all three groups:Before receiving training, 0% to 37.5% of participants used DPIs correctly — in one group, not a single participant used the inhaler correctly without instruction.After reading the patient instruction leaflet, 58.3% to 93.3% used DPIs correctly.After getting instruction from a healthcare professional, as many as 99.2% of participants used DPIs correctly. As a general rule, you’ll want to review your instruction manual when you first receive your inhaler. To put it another way, you don’t want to wait until you feel the first symptoms of an asthma or COPD episode coming on.

Step-by-step instructions

Every DPI will come with its own unique manual, but the process of using your inhaler follows the same general steps:Remove the cap and load your device: Some DPIs come preloaded with medication. If yours doesn’t, you’ll need to load a capsule before each use — your manual will explain how.Hold your inhaler steady in one hand: Keep it level so nothing spills out. Never shake the inhaler, as this will break up the powder before you can breathe it in.Sit up straight and breathe out: This empties your lungs so you can take the biggest breath possible. Make sure to breathe away from the inhaler so you don’t accidentally scatter the powder.Close your lips around the mouthpiece: Create a tight seal so no air can escape. Avoid biting or licking the mouthpiece.Inhale through your mouth: Try to take as deep and fast a breath as possible, as if sucking the powder through a straw.Hold your breath for 10 seconds: Don’t worry if you can’t taste or feel the medication — it’s still working.Breathe out slowly: Again, avoid breathing into the inhaler, since the moisture from your breath can stick to the inside of the device. Saliva or water might cause additional doses of powder to clump.Repeat steps 1 to 7 if needed: If your treatment calls for multiple doses, wait 1 minute before repeating the previous steps.Do a post-treatment rinse and spit: If your medication is a corticosteroid, you’ll need to rinse your mouth out with water. This helps prevent oral thrush since corticosteroids can weaken the immune system inside your mouth. Following these steps exactly can help your body consistently take in as much medication as possible. It may help to take extra care with steps 3, 6, and 7, as research suggests people most commonly make mistakes with these steps.

How to maintain your inhaler

Taking care of your DPI keeps it in good working condition. These tips can help make your inhaler last as long as possible:Wipe down the mouthpiece with a dry cloth after each use.Never use water to clean your device. The inside must stay dry.Keep your inhaler closed when you’re not using it.Store your inhaler in a cool, dry place. If you typically store medications in your bathroom, you may want to find a different place for your inhaler and avoid storing it near your shower or sink.

Pros and cons of dry powder inhalers

Wondering how a DPI compares with other kinds of inhalers? The benefits include:Ease of use: You don’t have to time your breath with a spray as you do with other inhalers. All you need to do is breathe in sharply through the mouthpiece — kids as young as 5 years old can master the technique.No propellants: Since DPIs contain no propellants, they pose less risk of environmental consequences.Resistance to contamination: So long as you take good care of your DPI, the device will be exceptionally resistant to bacteria, viruses, and fungi. Of course, no medical device is perfect. Some drawbacks of DPIs include:Moisture sensitivity: Water or saliva can interfere with the medication dispersal process, causing powder to stick inside the device.It may not work well in emergencies: If your airways have closed up, you might not be able to inhale deeply enough to suck out the powder.It may not work well for older adults: Some older adults may have trouble breathing quickly or deeply. According to 2017 research, up to 75% of older adults may find it difficult to inhale forcefully enough to activate the Turbohaler.

Safety and side effects

DPIs are generally safe to use, but some people may experience side effects or allergic reactions to the medication inside. While each medication is different, some side effects remain pretty consistent across brands. Common side effects (meaning they occur in up to 1 in 10 people) include:headacheoral thrushfluttering heart rateincreased coughingchange in mucus color or more mucus in general These side effects are generally mild and often go away as treatment continues. But in some rare instances, you could experience more serious side effects, including:wheezingchest paintachycardia (fast heart rate)rise in your blood sugarcataracts or glaucoma If you experience any of the following issues, connect with a doctor or healthcare professional. They can offer guidance on how to minimize side effects while still controlling your asthma. They may, for instance, recommend switching to another kind of medication.If you’re lactose intolerant Most DPIs use lactose particles to keep the powdered medication from clumping. A standard dose usually doesn’t contain enough lactose to cause problems for people with lactose intolerance, but some people may have a higher sensitivity.

If you have any concerns, you may want to ask a doctor for a DPI that uses another kind of carrier particle.

The bottom line

DPIs contain powdered medication that you breathe in to treat asthma or COPD symptoms. Many people find them fairly simple to use, but it’s important to learn the correct process and complete all the steps in order so you get the maximum benefit from your inhaler. If you think this inhaler may work well for your needs, ask a doctor or other healthcare professional about giving it a try. Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn. Last medically reviewed on October 14, 2022

How we vetted this article

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Asthma medicines and treatment. (2021).
aafa.org/asthma-treatmentBarbara S, et al. (2017). Inhaler technique: Does age matter? A systematic review.
err.ersjournals.com/content/errev/26/146/170055.full.pdfDe Boer AH, et al. (2017). Dry powder inhalation: Past, present, and future.
tandfonline.com/doi/full/10.1080/17425247.2016.1224846How to use a dry powder inhaler (DPI). (2022).
allergyasthmanetwork.org/what-is-asthma/how-is-asthma-treated/how-to-use-a-dry-powder-inhaler/How to use dry powder inhaler. (2021).
nhlbi.nih.gov/sites/default/files/publications/How-to-Use-a-Dry-Powder-Inhaler_21-HL-8164.pdfJindal SK, et al. (2021). Dry powder inhalers: Particle size and patient-satisfaction.
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ncbi.nlm.nih.gov/pmc/articles/PMC6822825/Lifsar Pulmojet 50 microgram/500 microgram per metered dose inhalation powder. (2017).
hpra.ie/img/uploaded/swedocuments/2189565.PA0540_174_001.d60c9be0-f919-425f-841c-3a7554710135.000001PIL.170419.pdfSandler N, et al. (2016). Evaluation of inhaler handling-errors, inhaler perception and preference with Spiromax, Easyhaler and Turbuhaler devices among healthy Finnish volunteers: A single site, single visit crossover study (Finhaler).
ncbi.nlm.nih.gov/pmc/articles/PMC4809147/Symbicort Turbohaler 200/6 inhalation powder. (2020).
medicines.org.uk/emc/product/1327/pilVelsor-Friedrich B, et al. (2009). Switching from CFC to HFA inhalers: What NPs and their patients need to know.
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kidshealth.org/en/parents/nebulizer-inhaler.htmlOur experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 14, 2022 By Emily Swaim Edited By Crystal Raypole Medically Reviewed By Philip Ngo, PharmD Copy Edited By Kristin Hitchcock Share this articleMedically reviewed by Philip Ngo, PharmD — By Emily Swaim on October 14, 2022

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