What Is a Nebulizer—And How Do You Use It?
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Medically reviewed by Daniel More, MD
A nebulizer is a medical device that turns liquid medicine into mist or aerosol that you inhale directly into your lungs. Medications used to treat respiratory conditions such as asthma, cystic fibrosis, and chronic obstructive pulmonary disease (COPD) are sometimes given via a nebulizer machine.
Nebulizers include a container to hold liquid medicine, an air compressor to generate airflow and turn the liquid into mist, and a mouthpiece or mask. They can be easier to use than inhalers for some people, including young children and people with severe respiratory conditions. This is because they do not require a specific breathing technique: you simply breathe normally into the mouthpiece or a mask.
Learn more about types of nebulizers, who might benefit from using them, and how to use and clean them.
Types of Nebulizers
Nebulizers can be plug-in or battery-operated. A tabletop machine is a bit larger and needs to be plugged into an electrical outlet or car adaptor. A battery-operated machine is smaller and more portable, making it a more convenient choice for use outside your home.
Nebulizers come in three main types: jet, mesh, and ultrasonic. Each type works differently and has advantages and disadvantages.
Jet Nebulizer
A jet nebulizer is the most commonly used nebulizer. It uses an air compressor to convert liquid medicine into mist or aerosol. Jet nebulizers are usually available in two different forms:
Conventional: This nebulizer produces a continuous mist of medication. It requires a higher dose of medication because most of the medication is lost during exhalation (breathing out).
Breath-actuated and breath-enhanced: These nebulizers only generate mist during inhalation (breathing in). As a result, it delivers most of the medication to your lungs with minimal waste.
Ultrasonic Nebulizer
An ultrasonic nebulizer uses high-frequency vibrations to transform liquid medication into aerosol form. This type of nebulizer is much quieter than a jet nebulizer.
Ultrasonic nebulizers cannot convert dense liquid into aerosol droplets. Therefore, you would not use this type of nebulizer to administer suspensions. A suspension is a type of medication in which the drug does not fully dissolve, leaving small particles of the drug floating in the liquid. Antibiotics, like Amoxil (amoxicillin), and some medications used to treat epilepsy are examples of suspension medications.
Mesh Nebulizer
A mesh nebulizer uses a mesh, or screen with tiny holes, to transform liquid medication into a fine mist. Mesh nebulizers administer medication more efficiently than jet and ultrasonic nebulizers, and they operate silently. They're also generally more portable.
Who May Need a Nebulizer
Nebulizers can help treat chronic respiratory conditions such as:
Asthma: A condition that causes inflammation of the lungs and airways, causing episodes of wheezing, coughing, chest tightness, and difficulty breathing
Chronic obstructive pulmonary disease (COPD): A group of conditions in which lung damage restricts airflow and causes difficulty breathing
Bronchiectasis: A condition in which lung bronchi—tubes that serve as the main passageway to the lungs—widen and loosen, causing breathing problems
Cystic fibrosis: A genetic condition that causes thick, sticky mucous to clog the lungs and affect breathing
Many people with these conditions use nebulizers to take medications, including:
Bronchodilators: A class of medications that relax and widen airway muscles in the lungs
Corticosteroids: A class of medications that help prevent inflammation of the lungs and airways
Antibiotics: A class of medications that can help fight bacterial infections
Sterile saline solution: A mixture of salt and distilled water that can help break up mucous
Nebulizers can also administer multiple medications at once.
Nebulizers might be used in conjunction with or instead of inhalers. An inhaler is a small, handheld device that delivers medication through a spray mist you breathe in. Nebulizers may be easier to use than inhalers, especially for young children. An inhaler requires learning a specific breathing technique, while a nebulizer only requires breathing normally. However, they take longer than inhalers, which might be challenging for very young children.
Nebulizers can also be helpful for people who have a difficult time using inhalers due to arthritis.
You typically need a nebulizer prescription from a healthcare provider, but most insurance plans cover it. Even if you can purchase the machine over the counter, you will need a prescription for the medications.
Related:Why You Shouldn't Use Tap Water in Humidifiers, Neti Pots, or Other Home Medical Devices
How To Use a Nebulizer
Nebulizers are relatively easy to use; you take the medication by simply breathing normally through the mouthpiece or mask.
A nebulizer has five basic parts:
A cup that holds the liquid medicine
A top piece or a cap that fits on top of the cup
A mouthpiece or mask, depending on what your healthcare provider recommends
Thin plastic tubing that connects the mouthpiece to the machine
An air machine called a compressor, which you can plug into an outlet or car adapter if it's not battery-operated
All types of nebulizers work similarly. Here are the basic steps to set up and use your nebulizer:
Place the machine on a hard, flat surface.
Assemble all pieces of the nebulizer per the manufacturer's instructions, and make sure they are clean.
Pour the prescribed medication dose into the medicine cup.
Attach the top piece to the medicine cup.
Attach the mouthpiece or mask to the top piece.
Connect the tubing to the compressor and medicine cup.
Put the mouthpiece into your mouth between your teeth. Close your lips tightly around it so no air leaks out when you breathe. If you use a mask, place the mask over your face so it tightly covers your mouth and nose.
Turn on the nebulizer machine. You should see a light mist coming from the back of the mouthpiece. Hold the medicine cup in an upright position to avoid spilling and wasting medicine.
Breathe normally until the medicine cup is empty or the mist stops. It may take up to 20 minutes to empty the medicine cup, depending on the dosage.
When finished, remove the mouthpiece or mask and turn off the nebulizer.
If you are taking inhaled corticosteroids, rinse your mouth with water and spit it out. This helps prevent a mouth infection.
Clean the nebulizer pieces per the manufacturer's instructions.
When helping a child use a nebulizer, you can hold the mouthpiece under the child's nose and mouth for ease. However, a mask is recommended for children under five years of age or until the child can use the mouthpiece effectively. This results in less medication loss.
The frequency of nebulizer use depends on the condition and medication. For example, albuterol, a medication used to treat asthma, is typically used three or four times a day.
Possible side effects include increased heart rate and jitteriness, but they typically don't last long. Always follow your healthcare provider's instructions when using a nebulizer.
How To Clean a Nebulizer
Cleaning your nebulizer after each use prevents the spread of germs and keeps the machine working effectively. It also prevents bacteria and mold from growing. Mold can cause an infection, especially for someone with weakened immunity.
Follow these instructions to clean your nebulizer:
Unplug the nebulizer.
Remove the tubing and set it aside. Never place the tubing underwater.
Remove the mouthpiece or mask, medicine cup, and top piece. Wash them in warm soapy water and rinse, or place them on the top shelf of a dishwasher.
Remove the excess water and let them air-dry on a paper towel until the next use.
You may also need to disinfect your nebulizer weekly:
Disinfect the mouthpiece or mask, medicine cup, and top piece. You can disinfect them by soaking them in a solution of white vinegar and water for 30 minutes, boiling or microwaving them for five minutes, or using a dishwasher. Follow the instructions provided by the nebulizer manufacturer.
Rinse and air-dry the pieces in a cool dry place.
Wipe the outside of the machine with a cloth as needed.
Do not wash the tubing: Wipe the outside with a cloth as needed and replace the tubing if the inside looks dirty.
Store the nebulizer parts in a clean plastic bag between uses. If multiple people use the nebulizer, use a separate bag for each person.
Most nebulizer compressors have filters that need to be replaced every six months or so. You may also need to replace worn or damaged parts over time. Follow the instructions provided by the manufacturer.
A Quick Review
A nebulizer is a small machine that transforms liquid medicine into a fine mist. Breathing in this mist carries the medication to your lungs. Unlike an inhaler, you don't need to learn a specific breathing technique—you simply breathe normally into the mouthpiece or mask.
Nebulizers are typically used to help treat respiratory conditions such as asthma and COPD. They can be easier to use than inhalers, particularly for young children and people with severe lung conditions or arthritis.
Always use and clean your nebulizer by following instructions provided by your healthcare provider and the machine manufacturer.
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