What is an inhaler dose?
A dose is the amount of medication to be taken at the recommended time. In the case of inhalers, particularly inhalers for the treatment of asthma, the dosage depends on the type of inhaler and the type of medication. Metered dose inhalers such as albuterol inhalers are usually used as rescue inhalers, but can also be used 15 to 30 minutes before exercise for those with exercise-induced asthma. When used to treat an asthma attack, the dosage is one or two puffs of the inhaler waiting a minute between puffs and can be taken every 2 to 4 hours as needed until asthma symptoms are resolved. This is the recommended dosage for all types of reliever inhalers (such as ProAir-HFA and Xopenex). Controller inhalers are usually used every morning and night and the dosage ranges from one to two puffs. These inhalers come as both metered dose inhalers and dry powder inhalers. Usually with metered dose controller inhalers, the dosage is two puffs twice a day (ex. Symbicort and Qvar), but with the dry powder controller inhalers the dosages can differ. For example with the Advair Diskus, the dosage is one puff twice a day, but with the Spiriva Handihaler which is commonly used for chronic obstructive pulmonary disease (COPD), the dosage is one puff once a day.
Dry powder inhalers come as multiple dose devices, which contain up to 200 doses in the device, and single dose devices that require you to place a capsule in the device immediately before each treatment so the device itself cannot hold more than one dose at a time.
Dosage instructions and proper inhaler use can often be confusing for patients because they might hear that they need to take two doses of the medication and rather than perform the steps required to inhale the medication (see figure below on how to use an inhaler) then repeat the whole process for the second inhaler dose, they might translate that to mean that they need to press the canister of the inhaler twice and inhale, which is incorrect.
Proper Use of MDIs
It is important for asthmatics with both pediatric asthma and adult asthma to receive proper instruction on how to use their inhalers and to practice using their inhaler often, especially when they are first given an asthma diagnosis. Because there are many new inhalers on the market and many patients use multiple inhalers with different dosage instructions, it is important for doctors to educate patients about asthma and the proper use of inhalers and to help with asthma management so patients can have adequate asthma control.