Your inhaler’s dose indicator helps track how much medication remains, but changes in the indicator, weak sprays, or blockages can affect how well it works. If these problems go unnoticed, you might not get the full dose when needed. This can be dangerous, especially during an asthma attack.
The dose counter moves after every few puffs, signaling when a refill is necessary. Ignoring this warning or using an expired inhaler can lead to reduced effectiveness. Sometimes, buildup inside the actuator blocks the spray, making it seem like medicine is being released when it’s not.
In this article, you will learn how to monitor the dose indicator, clean the inhaler, and ensure reliable medication delivery.
| 🔑Key Takeaways ➤ When the indicator turns red, your medicine is running low. Refill your prescription as soon as possible to avoid missing doses. ➤ If the counter shows “0,” the inhaler is empty. Stop using it immediately because it will not deliver the right amount of medicine. ➤ Medicine build-up inside the inhaler can block the spray. Clean the inhaler to remove residue if the dose counter moves but no medicine comes out. ➤ A weak spray means the inhaler might be clogged. Cleaning it properly ensures you receive the full dose every time. ➤ Expired inhalers may still spray, but the medicine might also not work. Using one can lead to poor symptom control, so replace it once it expires. ➤ Most inhalers provide 200 puffs. Keep track of your doses and replace the inhaler when you reach this limit, even if it still sprays. ➤ Regular cleaning prevents blockages and keeps the inhaler working. Follow the proper steps and let it air dry completely before using it again. |
Dose Indicator Changes
Inhalers use a dose indicator to tell you when it’s time for a refill. The indicator uses both colors and numbers to signal the remaining doses.
Each actuation releases 120 mcg from the valve and 108 mcg from the mouthpiece (which equals 90 mcg of albuterol base). Each canister provides 200 inhalations, and the dose indicator moves after every 10 puffs. You must pay close attention to these details to always get the proper dose when using your inhaler.
Red Background on Dose Indicator
Source: Lupin
When the dose indicator turns red, it signals that your medicine is running low and that you must refill your prescription. The red background is a clear reminder that the inhaler’s remaining doses are nearly exhausted.
When you see this warning, you should immediately contact your pharmacy or healthcare provider. This alert prevents you from using an inhaler that may not provide the full prescribed dose, which could affect your treatment.
Dose Indicator Approaches “20” and “0”
Observe the numbers on your inhaler. When the indicator shows “20,” it tells you that your inhaler is almost empty and only a few sprays remain. This means you are close to the end of the canister’s capacity.
More importantly, when the dose indicator stops moving at “0,” it indicates that the inhaler has no more usable medicine. Continuing to use the inhaler after it reaches “0” will not give you the proper dose, and it can compromise your health.
Therefore, you must discard the inhaler immediately once the counter reaches “0.”
| 📝 Quick Note The instructions for those using Ventolin HFA have specific details that differ slightly from other inhalers. When the counter on your Ventolin HFA reads “020,” you are nearing the end of your medicine supply and should contact your healthcare provider for a refill. The “020” reading is a critical early warning to ensure you do not run out unexpectedly. Furthermore, when the counter reads “000,” you must throw the inhaler away immediately because it will not deliver medicine properly. This precaution is necessary to avoid the risk of receiving an inadequate dose during an asthma attack or when you most need the medication. |
Inadequate Spray and Medicine Build-Up
An inhaler may not work correctly when medicine builds up inside it. This build-up can block the spray and cause problems with the dose you receive.
Full Spray Failure
If you press down on your inhaler and do not get a full spray, it is a sign that medicine build-up is blocking the spray mechanism.
Even though the inhaler counts the dose, you might see a weak or incomplete spray. This often happens because residue accumulates in the actuator, reducing the force of the spray. It is not enough to ignore this issue.
Instead of ignoring a weak spray, you must clean your inhaler by following specific steps, as outlined below.
Visible Dose Indicator Movement Without Medicine
Sometimes, you may notice that the dose indicator moves, which tells you that a spray was activated, but no medicine comes out. This is another sign that medicine build-up is interfering with the spray.
Even though the counter shows that a dose has been released, you are not receiving the correct amount of medication. The indicator moves because it is counting every press, but if there is build-up blocking the nozzle, the medicine cannot be delivered. In this case, you should clean your inhaler immediately to remove the residue.
Following the cleaning steps instructions, as mentioned above, is crucial. Make sure you allow the actuator to air dry completely after cleaning so that the medicine flows freely during your next use.
Expiration and Effectiveness
An inhaler comes with an expiration date printed on its packaging. You must follow this date so your medicine works as it should. A high-performance liquid chromatography (HPLC) study found that many expired albuterol and montelukast inhalers still contained more than 90% of their active ingredients. However, this does not mean you should use an expired inhaler.
Expired Inhaler Warning
Do not use your inhaler after the expiration date printed on its packaging. Once this date passes, the active ingredients may degrade, and the medicine may lose potency. Although the study showed that many expired lots had over 90% of the listed strength, the risk of reduced effectiveness remains.
Even if your inhaler still sprays, it might not deliver the complete or correct dose during an asthma attack. The Ventolin HFA guidelines clearly warn that using an expired inhaler can leave you without adequate treatment. Therefore, discard your inhaler immediately after it expires.
Do not use your inhaler after the expiration date printed on its packaging. Once this date has passed, the active ingredients in the medication may begin to degrade, and the medicine may lose its potency.
Reduced Effectiveness After Expiration
Even if your inhaler appears to have medicine left after the expiration date, its potency may be diminished. Over time, the active ingredients in the inhaler break down, which means that even though the inhaler still sprays, the strength of the medicine may not be sufficient to control your asthma symptoms effectively.
While an expired inhaler might retain a small amount of its original potency, it is unreliable for treating an asthma attack or preventing symptoms. This reduced effectiveness puts you at risk of receiving an inadequate dose, which can lead to poor control of your condition.
For your safety, replacing your inhaler as soon as it expires is best to ensure you are using a product that delivers the full prescribed dose of medication.
Maintenance and Usage Guidelines
Proper maintenance of your inhaler is crucial for ensuring it works reliably when you need it. Following these detailed steps will help you keep your device clean and ensure you receive the full dose of your medication.
Cleaning and Preventing Blockages
Regular cleaning with warm water is essential to prevent blockages from medicine build-up. Specifically for Lupin, follow these specific steps:
- Remove the canister. First, take the metal canister out of the actuator. Be sure not to let the canister get wet.
- Remove the cap. Take off the cap covering the mouthpiece.
- Rinse the mouthpiece. Rinse the mouthpiece under warm running water for about 30 seconds. This helps to remove any visible residue.
- Clean the actuator. Hold the actuator under the faucet and run warm water through it for about 30 seconds. Then, turn the actuator upside down and let warm water run through the mouthpiece area for another 30 seconds. This helps clear any hidden build-up.
- Shake off excess water. Shake off as much water as possible from the actuator.
- Inspect for build-up. Check the mouthpiece for any remaining medicine build-up. If you see residue, repeat the cleaning steps.
- Air dry. Allow the actuator to air dry completely, preferably overnight, before reassembling the inhaler.
If you clean your inhaler as directed and still do not get a full spray, it might be time to replace the inhaler. A full, clear spray is necessary to ensure you receive your full prescribed dose of medication.
Counting Puffs for Replacement
Most albuterol inhalers are designed to provide 200 puffs. It is important to count your doses as you use the inhaler. Here’s how to do it:
- Track each puff. Keep a record of every dose you take, especially if your inhaler does not have a built-in dose counter.
- Know your limit. Once you have used 200 puffs, you should replace your inhaler. Even if the inhaler appears to still spray, continuing to use it after 200 puffs may mean you are not getting the correct amount of medicine.
- Maintain accurate records. If your inhaler has a dose counter, check it regularly. If not, consider keeping a simple tally to ensure you know when you reach the 200-puff mark.
| 🤔 Did You Know? A multicenter study showed that integrated dose counters were very reliable, with a discrepancy rate of only 0.76% when compared to patient-recorded doses, and 92% of patients felt that the counter helped prevent them from running out of medication. |
Wrap Up
The dose indicator helps you track how much medicine is left, so check it often. When the counter turns red or reaches “0”, refill or replace the inhaler immediately. Using an empty inhaler will not give you the right dose.
Blockages can also cause problems. If the spray is weak or no medicine comes out, clean the inhaler to remove buildup. This keeps the medicine flowing as it should.
Expired inhalers may still spray, but they might not work well. Don’t take the risk—replace them on time. Keeping your inhaler clean, tracking doses, and replacing it when needed ensures you always get the right treatment when you need it most.
Frequently Asked Question
How often should I clean my inhaler?
You should clean your inhaler at least once a week with warm water. This prevents medicine buildup, which can block the spray. Let it air dry completely before using it again.
Can I use my inhaler if it’s still wet from cleaning?
If you must use it before it fully dries, shake off as much water as possible, insert the canister, shake the inhaler, and spray it twice into the air. Use your dose as prescribed and clean it again after.
How should I store my inhaler?
Keep your inhaler at room temperature, away from heat and moisture. Do not store it in the bathroom or expose it to open flames, as it may explode under high temperatures.
Sources
- Exelan Pharmaceuticals, Inc. (n.d.). Albuterol sulfate – albuterol sulfate inhalant. DailyMed. Retrieved from https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=29e35e54-dbd6-4426-993f-893d7a4d69be
- Children’s Hospital of Philadelphia. (n.d.). When to replace or refill your child’s asthma equipment or medication. Children’s Hospital of Philadelphia. Retrieved from https://www.chop.edu/health-resources/when-replace-or-refill-your-childs-asthma-equipment-or-medication
- Kutty, R. G., Bevry, M., Hoffmann, P., & Abourashed, E. A. (2022). Determination of albuterol and montelukast post-expiry drug strength by HPLC. Heliyon, 8(8), e10104. https://doi.org/10.1016/j.heliyon.2022.e10104.
- Wasserman, R. L., Sheth, K., Lincourt, W. R., Locantore, N. W., Rosenzweig, J. C., & Crim, C. (2006). Real-world assessment of a metered-dose inhaler with integrated dose counter. Allergy & Asthma Proceedings, 27(6), 486–492. https://doi.org/10.2500/aap.2006.27.2921.