Understanding What Solutions Are to be Used Inside a Nebulizer

October 9, 2025 •

4 min read

According to a study referenced in PMC by Ehrmann et al., common nebulised therapies included bronchodilators, corticosteroids, and sterile electrolyte solutions. A comprehensive understanding of what solutions are to be used inside a nebulizer is crucial for ensuring the safety and effectiveness of your respiratory treatment.

Quick Summary

This guide provides an overview of the sterile solutions and prescribed medications, including bronchodilators and saline, that are safe for nebulizer use. It highlights the importance of following medical advice and avoiding dangerous unapproved substances.

Key Points

Only Use Prescribed Solutions: Never put unprescribed liquids, like tap water, distilled water, or essential oils, into your nebulizer, as these can cause severe lung damage or infection.
Understand Saline's Role: Use sterile saline solution (0.9% sodium chloride) to thin mucus or dilute prescribed medication, and understand that hypertonic saline is for severe congestion under medical guidance.
Know Your Medications: Common nebulizer medications include bronchodilators (e.g., Albuterol) to open airways, corticosteroids (e.g., Budesonide) to reduce inflammation, and antibiotics for specific infections.
Avoid Unapproved Mixing: Do not combine different medications in the nebulizer cup unless explicitly told to by a healthcare provider, as some combinations can be chemically incompatible.
Follow Proper Hygiene: Always wash your hands before handling nebulizer equipment and clean and disinfect the parts regularly to prevent bacterial and fungal growth.
Ensure Correct Dosage: Use pre-measured, unit-dose vials whenever possible or use sterile droppers for dilution to ensure you are receiving the correct and consistent dose.

A nebulizer is a medical device that converts liquid medication into a fine mist, allowing it to be inhaled directly into the lungs. This delivery method is particularly effective for treating respiratory conditions like asthma, COPD, and cystic fibrosis. However, not just any liquid can be used. It is critically important to only use solutions that are specifically prescribed by a healthcare provider and formulated for inhalation, as using the wrong substance can lead to serious health complications.

The Foundation: Sterile Saline Solutions

Sterile saline is a cornerstone of nebulizer therapy, often used to dilute medications or for therapeutic purposes on its own. It is a sterile mixture of salt and water, with a concentration carefully chosen to be safe for inhalation.

Normal Saline (0.9% Sodium Chloride)

Normal or isotonic saline (0.9% sodium chloride) is a preservative-free solution that closely matches the body's natural fluids.

Mucus Clearance: It helps to loosen and thin mucus in the airways, making it easier to cough up and clear the lungs.
Moisture: It adds moisture to the respiratory tract, which can soothe irritation from a dry cough.
Diluent: It is frequently used to dilute other, more concentrated medications before they are nebulized.

Hypertonic Saline (e.g., 3%, 7%)

Hypertonic saline has a higher salt concentration than normal saline and is specifically used to help clear very thick mucus and congestion. It draws water into the airways, helping to break down thick mucus plugs. This is often used for conditions like cystic fibrosis or severe bronchitis, but should only be used under a doctor's supervision due to its stronger effects.

Prescription Medications for Nebulizers

Beyond sterile saline, a wide array of powerful prescription medications can be nebulized to treat specific respiratory problems. These are never interchangeable and should only be used exactly as prescribed by a healthcare provider.

Bronchodilators: Opening the Airways

Bronchodilators are medications that work by relaxing the muscles around the airways, causing them to open up and allow for easier breathing. They are typically used for quick relief during an asthma attack or a COPD flare-up.

Albuterol (Salbutamol): A fast-acting bronchodilator for immediate relief of bronchospasm.
Levalbuterol: Another short-acting bronchodilator similar to albuterol.
Ipratropium Bromide: An anticholinergic bronchodilator often used for COPD.
Combination Medications: Products like DuoNeb combine albuterol and ipratropium for a broader bronchodilating effect.

Corticosteroids: Reducing Inflammation

Inhaled corticosteroids are anti-inflammatory drugs used to prevent and control the inflammation that causes chronic respiratory symptoms. They are not for immediate relief but for long-term management.

Budesonide (Pulmicort): A common corticosteroid used to manage inflammation in the airways.
Fluticasone: Another inhaled steroid for long-term control.

Antibiotics: Fighting Infections

For certain lung infections, particularly in patients with cystic fibrosis or bronchiectasis, specific antibiotics are administered via nebulizer. This allows the medication to be delivered directly to the site of the infection. Examples include tobramycin and colistin.

Mucolytics: Breaking Down Mucus

Mucolytic agents help break down the bonds in mucus, making it less thick and sticky. This makes it easier for the body to clear the airways of phlegm. Dornase alfa is an example specifically used in cystic fibrosis.

What Not to Use in Your Nebulizer

It is imperative to know what should never be placed in a nebulizer. Using unapproved substances is extremely dangerous and can lead to severe lung damage, infection, or a medical emergency.

Tap Water or Distilled Water: These are not sterile and contain microorganisms and minerals that can cause infection and severe lung irritation, leading to bronchospasm.
Essential Oils or Aroma Oils: These are not intended for inhalation and can cause severe lung inflammation, damage, and chemical pneumonia.
Non-Sterile Solutions: Only use sterile solutions explicitly labeled for inhalation. Any other liquid, such as homemade saline from non-sterile ingredients, poses a significant risk of infection.

Comparing Common Nebulizer Solutions


Solution Type	Primary Function	Primary Conditions	Diluent Use
Normal Saline (0.9%)	Thins mucus, moisturizes airways	Mild congestion, dry cough	Yes, for most nebulizer medications
Hypertonic Saline (3-7%)	Breaks down thick mucus	Severe congestion, cystic fibrosis	No, used for its own therapeutic effect
Bronchodilators (e.g., Albuterol)	Opens airways	Asthma, COPD exacerbations	Some are pre-mixed; can be diluted with normal saline
Corticosteroids (e.g., Budesonide)	Reduces airway inflammation	Chronic asthma, COPD	Pre-mixed suspensions; do not dilute without medical advice
Antibiotics (e.g., Tobramycin)	Fights lung infections	Cystic fibrosis, bronchiectasis	Only as directed by the manufacturer and prescribing doctor

Proper Handling and Administration

For effective and safe nebulizer treatment, following proper procedures is just as important as using the correct solution. Always wash your hands before preparing your medication. Use pre-measured unit-dose vials whenever possible to ensure accuracy and sterility. If diluting medication, use a separate, sterile dropper for the saline. Never mix multiple medications in the nebulizer cup unless explicitly instructed to do so by a healthcare provider, as some drug combinations can be chemically incompatible. After each use, clean and air-dry the nebulizer cup and mask or mouthpiece to prevent bacterial growth and cross-contamination. For more information on nebulizer safety and usage, consult resources from trusted organizations like the American Lung Association.

Conclusion

The solutions used in a nebulizer are far from one-size-fits-all. They range from simple sterile saline for basic moisturizing and mucus clearance to complex, prescription-only medications targeting specific respiratory issues. The single most important rule is to only ever use solutions that have been prescribed or recommended by a healthcare professional and are specifically formulated for inhalation. Never substitute with tap water, distilled water, or essential oils, as these pose a significant risk of serious lung injury. By adhering to a doctor's guidance and using only approved, sterile solutions, you can ensure your respiratory therapy is both safe and effective.

American Lung Association: How to Use a Nebulizer

Frequently Asked Questions

No, you should never put tap water or distilled water in a nebulizer. The water is not sterile and can introduce harmful bacteria and minerals into your lungs, which can cause severe infection and irritation.

Normal saline is a 0.9% salt solution used for general mucus thinning and dilution. Hypertonic saline (e.g., 3%, 7%) has a higher salt concentration and is used for more aggressive mucus breakdown in severe congestion, but should only be used as directed by a doctor.

No, it is extremely dangerous to use essential oils in a nebulizer. Inhaling these oils can cause severe inflammation, irritation, and damage to the lung tissue.

You should only mix medications if your healthcare provider specifically instructs you to do so. Some drug combinations are not compatible and can lose their effectiveness or cause adverse reactions if mixed.

Nebulizers can deliver several types of medication, including bronchodilators like albuterol to open airways, corticosteroids like budesonide to reduce inflammation, and antibiotics for lung infections.

It is important to clean and rinse the nebulizer cup and mouthpiece or mask after every use. A more thorough disinfection should be done daily or weekly, following the manufacturer's instructions, to prevent infection.

If you use an unapproved or contaminated solution, you should stop the treatment immediately and contact a healthcare professional. Depending on the substance, it could lead to irritation, infection, or a serious allergic or asthmatic reaction.

Sterile saline is free of contaminants and microorganisms that could be harmful to the lungs. Using a non-sterile diluent increases the risk of lung infection.