COPD sufferer prescribed breathe acti... - British Lung Foun...

British Lung Foundation

45,917 members54,143 posts

COPD sufferer prescribed breathe activated dry powder inhaler? WHY


Followed a link to to inhalers for asthma shown on this site as a helpful link.

A section on this information said this......

Other breath-activated inhalers are also called dry powder inhalers. These inhalers do not contain the pressurised inactive gas to propel the drug. You don't have to push the canister to release a dose. Instead, you trigger a dose by breathing in at the mouthpiece. Accuhalers, clickhalers, easyhalers, novolizers, turbohalers, diskhalers and twisthalers are all breath-activated dry powder inhalers.

You need to breathe in fairly hard to get the powder into your lungs.!!!!!!

Some types are shown below.


I am on the Accuhaler & Turbohaler & don't feel as though I actually get a dose... reading the article, I am now wondering why an inhaler which exerts my lungs has been prescribed to me.. or am I missing something..

Yet another thing on my list to discuss with my locum doctor.. :-p..

The ability to reply to this post has been turned off.
32 Replies

Obviously a concern you need to discuss, but some of these devices are intended to make you use your lungs to get the dose into them. I have the 'Handhaler' device with Spiriva and you do need to give it a good suck to get the powder where it needs to go.

Even the conventional inhalers, with their pressurised puff of medication, will do nothing if the patient does not breath in properly as they take them. All it will do otherwise is to blast the stuff into the back of the throat.

Although I've never had it explained this way, I've always seen it as a short breathing exercise that does expand my lungs a bit more than they normally would be, and perhaps it's a good thing?

What do other users of these gadgets think ?

NuttyB in reply to Gordon57

Hi Gordon, I know what you mean & yes anything that forces you to excercise your lungs more is always a good thing, my prob is, that I generally feel like the medication is stuck at the back of my throat.. or is that just me..!!

Nancygirl in reply to Gordon57

I am a new user of Spirva for my COPD. I wanted to ask, some mornings its easy to breath the power in and other mornings its hard. Is there a reason for this, when its hard to breath in is the powder still getting into the lungs. I have been told that sometimes the Spriva caps can be empty without you knowing, is this correct?

Gordon57 in reply to Nancygirl

I covered the 'empty capsule' myth below, in reply to Lnne.

The action of inhaling the Spiriva dose should be the same each day, so it's telling me you are either having breathing problems that are affecting the attempt, or you may not have been shown the right way to use them?

Either way, it's worth discussing with someone. Try the BLF helpline, they can get someone to call you back, or your own surgery.

Nancygirl in reply to Gordon57

Thank you, I shall give the BLF a ring tomorrow. I was not told by my doctor how to use it he just said "put the capsule in the inhaler and take a breath deep breath in and hold" and that is what I have been doing. I do clean my inhaler often.

I have read all your comments and found them very helpful. Thank you very much.

Gordon57 in reply to Nancygirl

I hope he also mentioned pressing the button on the side to pierce the capsule before you inhale it...?

Good that you're calling the BLF, they will be able to explain the procedure to make sure you are doing it right, and may also be able to suggest other options if this particular method is not suitable for you.

Nancygirl in reply to Gordon57

Yes I am pressing the button, but I have notice sometimes there is only 1 hole in the capsule not two, would that be important. Thank you again Gordon

Gordon57 in reply to Nancygirl

Yes, it needs one hole at each end for the air to flow through to deliver the medication. Check it with the helpline and, if needs be, go back to your GP or even the chemist and get them to check the device with you.


You need to follow instructions that come with the breath activated inhalers. They vary so it will be worth checking your technique with each medicine is correct in accordance with instructions.

Also check your technique with your doc or surgery respiratory nurse just to be sure, so that you are getting the medicine as intended.

:-P (the smiley won't work with full stops after it) and meds definitely won't work if your tongue is stuck out :D ;)

HOpe you start getting relief from your meds real soon.

NuttyB in reply to Hidden

Zoee.. thanks for the heads up ;-p

NuttyB in reply to NuttyB


Hidden in reply to NuttyB

well done (but not when taking the meds) ;) :)

You're right Gordon (of course :) ) and thinking of it as a short breathing exercise is a good way to describe it.

I have Spiriva with the handihaler and find it helps a lot. When I take it each morning, I have a few practice breaths first to try and make sure I empty my lungs and get the technique right.

Also, I had read on here that some powder capsules are faulty and have nothing in them. I remember thinking that I wouldn't know but now I have come across a couple, it is easy to tell.

Lynne x

Gordon57 in reply to Lynne1955

A myth I'm afraid Lnne. The capsules have so little powder in them that it's near impossible to tell unless you open them up, which then renders the capsule useless. I squashed the end of one by accident, so I had a look for myself, a tiny tiny amount. The idea is that when the hand device spikes the capsule, top & bottom, the airflow through it will actuate the powder, swirling it round like one of those cyclic vacuum cleaners. The flow of air through sucking it is towards the lungs and that's how you end up inhaling the dose.

If the manufacturer had any issues with the dosage in the capsules, empty or otherwise, they would be in serious trouble. The inhaler device is designed to 'rattle' as you suck, to give an audible signal that it is working, I've found that the capsule has cracked, rather than be pierced, a couple of times and you don't hear quite the same thing. I've been assured that I am still getting the dosage needed and there's no danger of inhaling bits of the capsule as long as the mesh is intact. If that happens often then it's time to get a replacement device.

Lynne1955 in reply to Gordon57

That's really interesting Gordon, thank you. On the 2 occasions it has happened, I have had another. Still here, so I can't have overdosed, luckily. I don't think I will next time though.

Lynne :)

i too have these type of inhalers, i find them a bit of a struggle when i have a chest infection

i agree taking a big suck could help expand lungs though not sure if that is an added benefit


NuttyB in reply to linb

Actually I have a lung infection right now.. maybe the C can O only P plan D daily affects brain cells you can see why I call myself Nutty hey.

Happy Sunday everyone x

Gordon57 in reply to NuttyB

If you're blowing your brains out then you're sucking too hard ! :-D

It says inhale the capsule twice but I inhale the capsule four times because I always have to open the capsule to check it's empty and once there was some powder left in.

Gordon57 in reply to libbygood

Is the capsule being pierced properly, top and bottom? There should be two holes in it when you take it out. It might be worth getting someone at the surgery, or chemists, to check the HandiHaler for you and make sure it's working as it should.

Have to agree with the handihaler business. I have used a magnifying glass on occasion to if the capsule has actually been pierced! Especially if I hear it whizzing round quite cleanly! I tend to take mine at night rather than the morning - suggestion of a physio at pr. Just cuts down on the amount of stuff I take every morning.

Yes I too sit and have a few breaths first starting with small and gradually getting deeper until I am ready to have a deep as possible whiff - inadvertently have done an active cycle of breathing!!!! Goody two shoes that I am!

Might be worth having a chat to the chemist as they may also be aware of alternatives which you can ask your HCP about? Good luck


Getting good inhaler technique from your pharmacist or respiratory nurse can clear up problems with the how, what and when of it all as it can be hard to remember on a groggy morning.

Gordon57 in reply to mogli712

:-D cutting back on the grog may also help -

I have the respimat which is a fine mist it took a while to get the co-ordination pf pressing the button the same time as I inhaled but once conquered it was great.

I could not get on with the capsules used to stick in my throat and make me cough even more.


For the Spiriva have you tried the Respimat that fires a mist which you inhale ? I found this one so much better as you don't need as much effort as the capsules one.

I have the Spiriva Respimat but I seem to wasting quite a lot of it by checking that it is working. I don't feel anything happens when I take it. I thought it was just me!!

I found the Spiriva capsules hard to activate. The respiratory nurse had a gadget to test how hard you could breathe in. To activate the capsule correctly you had to be able to reach the number 60. I could only reach 50 so was prescribed Respirmat the fine mist spray which only requires a light suck in and is so much better especially when you have an infection and have not got much puff.

Gordon57 in reply to eepee8

Once again, the forum is educating people - great stuff. Correct, you do need to be able to give the capsule device a good suck and breath in, and they can measure this - if they know about it. Not all surgeries have the gadget to do the test, from what I've surmised?

eepee8 in reply to Gordon57

This is true - unfortunately there is no standardisation across the UK only recommendations.

It's a shame that more people aren't aware of the options. Not all surgeries recommend it as it costs more than the Spiriva capsules.

i have just started on the capsule device, and i have been told to inhale slowly and softly, is this not correct ????

rob3 in reply to cliffy66

Breathe out completely. Then, with the HandiHaler in your

mouth, breathe in deeply until your lungs are full. You should

hear or feel the SPIRIVA capsule vibrate (rattle).

Remember, to take your full daily dose, you must inhale twice

from the same SPIRIVA capsule

just copied this ,its how i take mine .

The ability to reply to this post has been turned off.

You may also like...