It is important for both adults and children to use a spacer with a metered dose inhaler, as the spacer helps the medicine get to the small airways where it is most needed.

When is a metered dose inhaler prescribed?

A metered dose inhaler contains the medication in a hand-held pressurised canister. It delivers one dose at a time from the canister that contains multiple doses. It is prescribed for people with asthma or other lung conditions.

People with asthma or carers sometime ask about the benefits of using a nebuliser or an inhaler. Using salbutamol, a common medication to relieve the symptoms of asthma, with a metered dose inhaler (blue/grey puffer) along with a spacer is just as effective as using a nebuliser.

With a spacer the medication is delivered over a shorter period of time, making it easier to breathe in and wasting less medication. Whether you are an adult or a child, the spacer helps the medicine reach the small airways where it is most needed. Without a spacer, medication may remain in your mouth and at the back of your throat.

Metered dose inhalers have many other advantages compared to a nebuliser. They do not need a power source and expensive equipment, are easily portable and are quick to use.  A small volume spacer with a tightly fitting face mask may be needed for children younger than 4 years or for people who cannot seal their lips tightly around the mouthpiece of an inhaler or spacer.

Metered dose inhalers (puffers) with a spacer are at least as effective as a nebuliser for the delivery of salbutamol for adults and children, even during symptomatic flare-ups.

When are salbutamol nebules prescribed?

Salbutamol nebules can be prescribed for the relief of bronchospasm (when the muscles that line the bronchi, the airways in your lungs, tighten). This can occur in patients with asthma or chronic obstructive pulmonary disease (COPD). The medication is breathed in as a fine mist.

Salbutamol nebules are also prescribed to help prevent exercise-induced asthma or in other situations that can bring about bronchospasm.

The prescription of salbutamol nebules is restricted by the Pharmaceutical Benefits Schedule (PBS) to only be available for patients with asthma and COPD that are unable to use an oral pressurised inhalation device with a spacer.

The shortage of salbutamol inhalation solution 2.5mg/2.5mL (Ventolin nebules) that occurred in 2023 is now over and the nebules are available once again. The Salbutamol Cipla 2.5mg/2.5mL brand remains unavailable.

Update your treatment plan and check your technique

If you would like to find out more about the benefits of using a metered dose inhaler with a spacer and whether this is right for you, visit your GP for a discussion and update to your treatment plan. Ask your GP or pharmacist to demonstrate how to use an inhaler with a spacer and check your technique.

The National Asthma Council Australia has a range of helpful videos that demonstrate correct technique.

Watch our how-to videos for children and for adults on using a metered dose inhaler with a spacer.

Download this factsheet.