Pharmacist Raj Patel, known online as Pharmacist Health Raj, has issued a three-word reminder to anyone using a steroid inhaler: "Rinse and spit." The advice is aimed at reducing the risk of side effects such as a sore throat, a croaky voice, and oral thrush.
Over two million people across the UK rely on inhalers for conditions including asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, and respiratory infections. NHS prescribing data indicates that just over half of all inhalers dispensed contain steroids, which work to reduce swelling and mucus production.
Why the 'little step' matters
Patel explained: "After (taking) your steroid inhaler, rinse and spit. Here's why that little step really matters. This applies to inhalers that contain steroids. A little of the medicine stays in your mouth after you use them. So, afterwards, rinse your mouth out well with water and then spit it out. That helps reduce the chance of a sore throat, a croaky voice, and an infection in your mouth called thrush."
He added: "Inhalers differ, so check the leaflet or let your pharmacist show you what yours needs. Keep using your as prescribed, don't stop it suddenly, and check your leaflet today. Does yours say, 'Rinse and spit'?"
Types of inhalers and how they work
Inhalers deliver medicine rapidly into the lungs, most commonly to manage asthma and COPD. Some devices, known as combination inhalers, contain two or more distinct types of medication, and patients using them may still require additional separate inhalers.
There are three main types of inhaler: pressurised metered dose inhaler (pMDI), dry powder inhaler (DPI), and soft mist inhaler (SMI). The GP or nurse prescribing an inhaler considers factors such as the medication required, dosage, suitability of the device, patient preference, whether a dose counter is needed, and the inhaler's carbon footprint.
Patients also receive instructions on how, when, and why to take the medication, along with details about the type of medicine it contains. pMDI inhalers frequently come with a spacer, a hollow plastic tube that ensures the correct amount of medicine is received with each use. A spacer is not required for dry powder inhalers or breath-actuated inhalers (BAIs).
Nebulisers are not inhalers
Devices known as nebulisers differ from inhalers. A nebuliser is a machine primarily used in hospital settings that converts liquid medicine into a fine mist, inhaled through a face mask or mouthpiece. Only a limited number of medicines are compatible with nebulisers.
An inhaler, by contrast, is a handheld device that administers medication as a spray or powder. Nebulisers for asthma are predominantly used in hospitals to treat severe asthma attacks rather than at home, and should only be used at home if prescribed by a doctor.
Signs that an inhaler is being used correctly include easing symptoms, improved sleep, regular exercise, and fewer asthma or COPD attacks or flare-ups.
