How long should I shake my AirSupra (albuterol) inhaler before use?

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AirSupra Shaking Instructions

You should shake your AirSupra inhaler for 5 seconds immediately before each use, with minimal delay between shaking and actuation.

Proper Shaking Technique

  • Shake the inhaler vigorously for 5 seconds before each actuation to ensure consistent drug delivery and proper dose emission 1.

  • Actuate immediately after shaking (within 1-2 seconds) to prevent dose variability 1.

  • Shake again before each subsequent puff if taking multiple doses, as delays between shaking and actuation can significantly alter the emitted dose 1.

Why Timing Matters

  • Research demonstrates that delays between shaking and actuating a suspension inhaler dramatically increase the emitted dose of the second actuation 1.

  • A 10-second delay results in 147% of the intended dose, a 20-second delay yields 187%, and a 30-second delay produces 227% of the nominal dose 1.

  • The mean delay in real-world use is approximately 13 seconds, which can result in 159% of the intended dose being delivered 1.

Complete Administration Sequence

  1. Shake vigorously for 5 seconds 1
  2. Actuate immediately (within 1-2 seconds of shaking) 1
  3. Inhale slowly over 5 seconds during actuation 2
  4. Hold breath for 10 seconds after inhalation 3, 4
  5. If a second puff is needed, shake again for 5 seconds before the next actuation 1

Common Pitfalls to Avoid

  • Never shake once for multiple puffs - this is the most common error and results in unpredictable dosing 1.

  • Avoid rapid inhalation (faster than 5 seconds), as this reduces bronchodilator effectiveness 3, 4.

  • Do not hold breath for less than 10 seconds, as shorter breath-holding (4 seconds) reduces bronchodilation 3, 4.

  • Never delay actuation after shaking, especially when using a valved holding chamber with children, as caregivers frequently make this error 1.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

How should a pressurized beta-adrenergic bronchodilator be inhaled?

European journal of respiratory diseases, 1981

Research

Simple instructions for using pressurized aerosol bronchodilators.

Journal of the Royal Society of Medicine, 1980

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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