when and how to use spacers with metered-dose inhalers (MDIs)

Questions often come up about when and how to use spacers with metered-dose inhalers (MDIs).

The original open-tube spacers (OptiHaler, etc) just added some distance between the inhaler and mouth...to limit how much drug hit the back of the throat. This can reduce local steroid side effects such as oral thrush or hoarseness...especially if rinsing the mouth isn't enough.

Valved holding chambers (AeroChamber Plus Flow-Vu, OptiChamber Diamond, etc) are preferred. They have the benefits of a spacer...AND "hold" the med to give a little more time to inhale.