Delivering asthma medication

Use a metered-dose inhaler (MDI) with:

• Beta2-agonists.
• Corticosteroids.
• Cromolyn sodium.
• Nedocromil sodium.
• Anticholinergics.

• Adults and children

• Most health professionals recommend that everyone who uses a metered-dose inhaler (MDI) also use a spacer, which is attached to the MDI. A spacer may deliver the medication to your child's lungs better than an inhaler alone and, for many people, is easier to use than an MDI alone. Using a spacer with inhaled corticosteroids can help reduce their side effects and result in less use of oral corticosteroids.
• A spacer is recommended for children age 5 and older.
• A spacer and a face mask are recommended for children younger than 5.
• Using a spacer with an MDI may be just as effective as and less expensive than a nebulizer and can reduce the risk of an overdose.
• If you don't use a spacer, you need to trigger a puff of medication and inhale at the same time.
• A breath-activated MDI is available for people age 12 and older who have difficulty inhaling while triggering a puff.

Use a dry powder inhaler (DPI) with:

• Beta2-agonists.
• Corticosteroids.

• Children 4 years and older and adults

• How well it works may depend on how well you breathe in.
• Your health professional determines the amount of medication you use based on how much air you can breathe in. It also may be different than the amount used in some MDIs.
• DPIs may be easy to use, but they may be difficult to use during an asthma attack because you need to be able to breathe well to get the best effect.

Use a nebulizer with:

• Beta2-agonists.
• Cromolyn sodium.
• Anticholinergics.

• Any age that cannot use an MDI with a spacer

• A nebulizer uses a face mask or mouthpiece to deliver the medication.
• The medication can be given over a long period of time.
• Nebulizers may be helpful for those who are ill, have serious difficulty breathing, or have trouble using an inhaler—especially infants, very young children, and older adults.
• A nebulizer is not very precise in delivering medication, and there is a risk of getting too much medication (overdose).