While some people with asthma use traditional inhalers to take their medications, others use nebulizers. These machines convert liquid medication into an aerosolized (fine) mist that you can inhale directly into your lungs through a mask or mouthpiece. Nebulizers are used for treating other conditions, including chronic obstructive pulmonary disease (COPD) and cystic fibrosis.

Using a nebulizer for the first time can be intimidating. Even if you read the directions, operating the device may not be intuitive. You also need to take precautions before and after using a nebulizer to keep it clean and ensure you’re getting the right dose of medicine.

MyAsthmaTeam members have expressed concern about using the device for the first time. One asked, “Anyone else use a nebulizer? I was just given one, and I don’t know how I feel about it.” Another member commented, “Just wondering if others use drugs via a nebulizer rather than inhalers. Is this cumbersome?”

The following tips can help you use a nebulizer safely and confidently.

1. Choose the Right Nebulizer for You

There are three main types of nebulizers, each with its pros and cons.

Jet Nebulizers

A jet nebulizer uses compressed air to turn the medication into a fine mist. This type of nebulizer is usually the least expensive and can be used with any type of medication.

However, these machines can be large and noisy.

Mesh Nebulizers

Mesh nebulizers use compressed air to force the medication through a mesh plate to create a fine mist. They’re usually smaller and more portable than jet nebulizers because they’re battery operated. They are also designed to shorten your treatment time.

However, medications that form crystals when they dry don’t work as well in mesh nebulizers. These devices can also be difficult to clean.

Ultrasonic Nebulizers

Ultrasonic nebulizers use sound vibrations to turn the medication into a mist and are usually quieter than other nebulizers.

They can also be more expensive than other nebulizers. Additionally, they work as well for liquid medications that are suspensions, such as budesonide (Pulmicort Flexhaler).

2. Get To Know Your Equipment

Each brand of nebulizer may be slightly different. Even if you think you know how to use a nebulizer, you should read through the manufacturer’s instructions before using it for the first time.

Make sure you have all of the necessary nebulizer parts. Most nebulizers have the following:

• An air compressor (the nebulizer machine)
• Tubing
• Medicine cup
• Mouthpiece or a mask

Follow the step-by-step instructions included with your device. The instructions should be similar to the following:

1. Wash your hands with soap and water or use a hand sanitizer.
2. Attach the nebulizer parts according to the instructions.
3. Pour your medication into the medicine cup, close it tightly, and keep it upright to avoid spilling.
4. If you’re using a mouthpiece, place it over your tongue and close your teeth and lips tightly around it. If using a face mask, place it over your mouth and nose to create a tight seal.
5. Turn on the machine.
6. Breathe through your mouth until all of the medicine is used and you don’t see any more mist. This usually takes between five and 20 minutes.
7. Turn off the machine.
8. If the medication was a corticosteroid, you should rinse your mouth with water.
9. Wash the medicine cup and mouthpiece or face mask.
10. Dry the pieces with a clean cloth or let them air-dry.

3. Check Your Medicine Before Using the Nebulizer

It’s important to check your medication before pouring it into the dosing cup to ensure:

• You have the correct medication
• The vial isn’t damaged
• The medication is not discolored
• There are no crystals or foreign substances in the liquid
• It’s not expired
• The medication hasn’t been exposed to extreme heat, cold, or light

When you open the vial and pour the medication into the nebulizer cup, you should also smell it to make sure it doesn’t have a foul odor.

Several asthma treatments can be used in a nebulizer, including:

• Bronchodilators, which open the airways — These include albuterol (Accuneb, ProAir, Proventil, Ventolin HFA), ipratropium (Atrovent), and levalbuterol (Xopenex HFA).
• Corticosteroids, which decrease inflammation — These include budesonide (Pulmicort Flexhaler), fluticasone (Arnuity Ellipta and Flovent), and triamcinolone (Azmacort).
• Antibiotics, which treat lung infections
• Sterile saline, which loosens mucus in the lungs

Only use asthma medications prescribed by your doctor in your nebulizer. Putting other liquids in the device and breathing them in can be dangerous. This includes other medications or chemicals such as hydrogen peroxide.

4. Choose Between a Face Mask and Mouthpiece

Whether you use a mouthpiece or a face mask is a personal preference. If you use a mouthpiece, you must hold it to your mouth during the whole treatment. Administering medication to yourself or a loved one may be easier with a mask.

One MyAsthmaTeam member said, “If you’re having a hard time, ask for a mask.”

A mask can make it easier for some people to get the appropriate treatment, including:

• Young children
• Older people
• People with problems using their hands (such as those with arthritis)
• People who have problems coordinating their breathing with a device

Make sure the mask is the right size. It should fit snugly over the mouth and nose. If the mask doesn’t fit well, the medication can escape through the sides.

Getting children to use a mask can sometimes be difficult. You can make it less scary by using specially designed pediatric nebulizers and masks decorated with the child’s favorite animals or cartoon characters. If the child is old enough, it may also help to allow them to participate in the process by holding the mask so they have some control.

Using a mask can free up everyone’s hands so you and your child can participate in a fun activity together during the treatment.

5. Keep It Clean

Cleaning your nebulizer regularly is important for keeping it hygienic and working properly and to prevent the spread of germs that can make you sick.

Check the manufacturer’s instructions for detailed information about how to clean your machine. In general, there are steps that should be taken after each use, once a week, and every six months. Wash your hands before handling your nebulizer and nebulizer parts.

After every use, you should take the following steps:

1. Take the nebulizer apart.
2. Wash the medicine cup, mouthpiece, and mask using warm water and soap — but not the tubing. If you use your nebulizer more than once per day, you can use warm running water for additional cleaning.
3. Shake off the excess water, place the parts on a clean paper towel, and allow everything to air-dry.

Give your nebulizer a deeper cleaning once a week by doing the following:

• Disinfect the mouthpiece, mask, and medicine cup by soaking them in a solution of one part distilled white vinegar and two parts water for 30 minutes.
• Use a damp cloth to clean the surface of the air compressor and the outside of the tubing. Do not wash the inside of the tubing.

Most nebulizers also have an air filter that should be replaced every six months. Check your manual for specifics.

6. Discuss Your Options With Your Doctor

Talk to your doctor about which asthma treatment or type of nebulizer is right for you or your child. Some things to consider when discussing your options include:

• Availability of the type of device
• Cost
• Portability
• Ease of use
• Time requirements
• Compatibility with your medication
• Access to electricity
• How well you can use your hands

Your doctor or pharmacist can teach you how to use your new nebulizer before you use it at home for the first time.

Talk With Others Who Understand

MyAsthmaTeam is the social network for people with asthma and their loved ones. Here, more than 10,000 members come together to ask questions, give advice, and share their stories with others who understand life with asthma.

Do you use a nebulizer? Share your experience and tips in the comments below, or start a conversation by posting on your Activities page.