A soft mist inhaler (SMI) is a handheld device for taking medicine that must be breathed into the lungs (inhaled). The device changes a liquid medicine into a mist that can be inhaled.

A soft mist inhaler is used when a disease causes the breathing tubes to narrow (bronchospasm). Using an SMI helps prevent bronchospasm and keeps the airway open. An SMI may be part of the long-term treatment for asthma or chronic obstructive pulmonary disease (COPD). The usual dosage is two inhalations every day.

What are the risks?

• If you do not use the inhaler correctly, medicine might not reach your lungs to help you breathe.
• The medicine in the inhaler can cause side effects, such as:
  • Chest tightness or difficulty breathing.
  • Eye redness, eye pain, or vision changes.
  • Difficulty passing urine.
  • Dry mouth or sore throat.
  • Cough.
  • Headache.
  • Sinus congestion (sinusitis).

Supplies needed:

A soft mist inhaler. The medicine that you need to breathe in comes in the inhaler. Each device contains the amount of medicine needed for 60 uses (30 daily doses of 2 inhalations).

How to use a soft mist inhaler

Preparing a new inhaler for use

1. Remove the clear base of the inhaler by pressing the safety catch on the cap with your thumb and pulling off the clear base with your other hand.
2. On the label, write down the date that will be 3 months from now. This is the date when you should throw away the inhaler.
3. Place the medicine cartridge that comes with the inhaler into the base of the inhaler. Press the cartridge on a flat surface to click it into place. Click the clear plastic base back into place over the cartridge.
4. Turn the clear base in the direction of the arrows on the label until you hear a click.
5. Open the cap on top of the inhaler. It should snap open all the way to show you the mouthpiece.
6. Prepare (prime) the inhaler for use. To do this, point the inhaler toward the ground and press on the dose-release button below the mouthpiece. You should see the release of some mist. Be careful not to get any mist into your eyes. If you do not see mist, close the cap, turn the base, open the cap, and prime the inhaler again until you see the mist. If you still do not see the mist, return the inhaler to your pharmacist for help.

Taking an inhaled dose

1. Hold the inhaler upright.
2. Use your thumb and pointer finger to turn the base of the inhaler until you hear a click. This means the dose chamber is ready to deliver the medicine.
3. Open the cap until you hear a click.
4. Hold the inhaler in one hand with your pointer finger over the dose-release button.
5. Turn your head away from the inhaler and breathe out slowly.
6. Close your lips around the mouthpiece.
7. Point the inhaler toward the back of your mouth.
8. Press the dose-release button while taking a slow, deep breath through your mouth.
9. Hold your breath for 10 seconds, or as long as you can.
10. Turn your head away from the inhaler and breathe out slowly through pursed lips.
11. Take a second inhalation if your health care provider told you to. Do not take extra doses even if you do not feel the mist as you inhale.

Follow these instructions at home:

Tips for using your inhaler

• Use a soft mist inhaler only as told by your health care provider.
• Do inhalations at about the same time each day.
• If you have not used the inhaler:
  • In more than 3 days, release a mist dose toward the ground before using.
  • In 21 days or more, open the cap, turn the base, and prime the inhaler until you see mist. Repeat these steps three more times before using the inhaler.

Caring for your SMI

• Store the soft mist inhaler at room temperature. Keep it out of reach of children.
• Clean the mouthpiece of the SMI with a damp, clean cloth once every week.

General instructions

• Check the indicator on the inhaler to keep track of your doses. When the indicator is in the red zone, you have 7 days left. Get a refill at this time. The inhaler will lock when it is empty.
• Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.
• Tell your health care provider about:
  • All your medical conditions. Use soft mist medicine with caution if you have glaucoma, an enlarged prostate, or kidney disease.
  • If you are or may become pregnant.
  • All medicines you take. Some medicines can interact with the medicines in the inhaler.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a very dry mouth or sore throat.
• You have a fever.
• You have a stuffy nose (nasal congestion) or nasal discharge.
• You have a cough that does not go away (is persistent).
• You have a headache.
• You have trouble passing urine.
• You are not sure how to use your inhaler or your inhaler is not working properly.

Get help right away if:

• You have an allergic reaction. Symptoms may include an itchy rash, swelling of the face or tongue, or difficulty breathing.
• You have severe and sudden eye pain or changes in vision.
• You have severe shortness of breath.
• You have difficulty breathing.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• A soft mist inhaler (SMI) may be part of the long-term treatment for asthma or chronic obstructive pulmonary disease (COPD).
• The usual dosage is two inhalations each day to prevent bronchospasm.
• Follow instructions carefully to use the inhaler properly.
• Get help right away if you have an allergic reaction, sudden eye pain, changes in vision, shortness of breath, or difficulty breathing.