These inhalers consist of a pressurized canister containing medicine that fits into a boot-shaped plastic mouthpiece. With most metered dose inhalers, medicine is released by pushing the canister into the boot.
Some types of metered dose inhalers release medicine automatically when you inhale. A few metered dose inhalers have built-in dose counters so that you know how many doses remain. Some newer devices use wireless technology to help you count doses by allowing you to track them with an app downloaded to your phone.
If your metered dose inhaler doesn't have a counter, you need to track the number of doses you've used to know when the inhaler is low on medicine. Or you can purchase a separate electronic dose counter to keep track.
For some people, such as for children or older adults, using a spacer or valved holding chamber with an inhaler might make it easier to inhale the full dose. A spacer holds medicine in a tube between the inhaler and your mouth after it's released. A valved holding chamber is a specialized spacer with a one-way valve to help control the flow of medicine.
Releasing the medicine into the spacer allows you to inhale more slowly. This increases the amount of medicine that reaches your lungs. Spacers and holding chambers require a prescription.