Inhalation Accessory Device (IAD)

Inhalation accessory devices, or IADs, are sometimes used to improve the function of metered-dose inhalers. The medicines that you inhale can only be effective if they reach the targeted airways. Unfortunately, if your positioning or timing is off, your inhaler may not be effective. Because the dose of medication usually bursts from the inhaler at close to 60 miles per hour, much of the medicine can be lost before it actually gets into your airways.

There are two general types of IADs: holding chambers and spacers. Both holding chambers and spacers extend the mouthpiece of the metered-dose inhaler and direct the medication toward your mouth. This reduces the amount of medication that is released into the air and increases the amount of medication that reaches your lungs. IADs help to deliver medication more effectively to your lungs and can reduce side effects.

Children should never use an inhaler without a holding chamber or spacer. Adults can also significantly benefit from the use of an IAD.

There are a variety of IADs available. Your provider can advise you on which type, if any, may work best for you.

View a demonstration on how to use an IAD with a mouthpiece.

When using an IAD with a mouthpiece, remember the following tips:

  1. Always read and follow the manufacturer’s instructions before using your IAD.
  2. Clean your IAD according to the manufacturer’s instructions or when the unit becomes cloudy or filmy inside. Time cleaning so that the IAD has a chance to air-dry completely before your next dose is administered. Replace disposable parts as recommended to avoid bacterial growth.
  3. Stand or sit up straight and remove any gum or candy from your mouth.
  4. Always shake the inhaler before using. Then insert the mouthpiece of your inhaler into the opening of the flat end of the IAD.
  5. Exhale completely and then place your lips tightly around the mouthpiece of the IAD. Spray one puff of your medicine into the IAD and immediately begin to inhale slowly and deeply. Then hold your breath 10 seconds, exhale, and repeat the entire process for any additional prescribed puffs.
  6. You should wait at least 15 to 30 seconds between each puff. This enables the inhaler device to draw up another full dose of medication.
  7. Never spray more than one puff of medication into a holding chamber or spacer at one time.
  8. Use a permanent marker to write the purchase date of the IAD on the side of the device. Discard your unit when advised in the package instructions or if the unit fails to operate as expected.

View a demonstration on how to use a spacer with a facemask for children.

To use a spacer with a facemask for children:

  1. Always read and follow the manufacturer’s instructions before using the IAD.
  2. Clean your child’s IAD according to the manufacturer’s instructions or when the unit becomes cloudy or filmy inside. Time cleaning so that the IAD has a chance to air-dry completely before your child’s next dose is administered. Replace disposable parts as recommended to avoid bacterial growth.
  3. Have your child stand up straight and remove any gum or candy from their mouth.
  4. Always shake the inhaler before using. Then insert the mouthpiece of your child’s inhaler into the opening of the flat end of the IAD.
  5. Spray one puff of your child’s medicine into the IAD and hold the facemask spacer in place for six breaths (approximately 10 to 15 seconds). Ensure that the mask makes a good seal and you can see the exhalation flap moving with each breath. Remove the spacer from the face and repeat the entire process for any additional prescribed puffs.
  6. Your child should wait at least 15 to 30 seconds between each puff. This enables the inhaler device to draw up another full dose of medication.
  7. Never spray more than one puff of medication into a holding chamber or spacer at one time.