What is the difference between Turbuhaler and inhaler?

October 8, 2025 •

4 min read

According to the American Thoracic Society, many patients have difficulty using a standard inhaler correctly, with some studies showing successful delivery rates as low as 15%. Understanding the core distinction, and how it impacts usage, is key to comprehending the difference between a Turbuhaler and inhaler types like the metered-dose inhaler (MDI).

Quick Summary

Turbuhalers are breath-activated dry powder inhalers, while most other inhalers are pressurized metered-dose devices. Key distinctions include medication form, activation method, and user technique, with each type having specific advantages and disadvantages depending on the patient's condition and ability.

Key Points

Delivery Mechanism: A Turbuhaler is a dry powder inhaler that uses a patient's breath to release medication, while a metered-dose inhaler (MDI) uses a pressurized propellant to release an aerosol spray,.
Inhalation Technique: Using a Turbuhaler requires a quick, deep inhalation to receive the dose. MDIs require a slow, steady inhalation perfectly coordinated with a press of the canister,.
Accessory Use: A Turbuhaler does not use a spacer. MDIs can be used with a spacer, which improves delivery and reduces the need for precise coordination,.
Patient Feedback: Turbuhalers often provide little to no sensation of receiving the dose, while MDIs typically produce a perceptible spray,.
Cleaning Differences: A Turbuhaler should be wiped with a dry cloth only, never washed with water. MDIs (without the canister) are typically cleaned with warm water,.
Medication Types: Turbuhalers often contain combination or maintenance medications (e.g., Symbicort), whereas MDIs are used for both rescue and maintenance treatments (e.g., Albuterol),.

Understanding the Basics: Inhalers and Inhalation

Before delving into the specifics of a Turbuhaler, it's important to recognize that the term 'inhaler' is a broad category encompassing several types of devices used to deliver medication to the lungs. The most common types, aside from nebulizers, are Dry Powder Inhalers (DPIs) and Metered-Dose Inhalers (MDIs). The Turbuhaler is a specific brand name of a multidose DPI. Therefore, comparing a 'Turbuhaler' to an 'inhaler' is essentially comparing one specific type of dry powder device to the broader class of aerosol-based devices.

The Turbuhaler: A Dry Powder System

The Turbuhaler is a cylindrical device that delivers a fine, dry powder medication directly into the lungs. It is a "breath-activated" device, meaning the patient's inhalation is the force that releases the dose from the device. This eliminates the need for the manual pressing and breath coordination required by many other inhaler types.

Key features and usage points of the Turbuhaler include:

Activation: The user loads the dose by twisting a color-coded grip or base and inhaling forcefully and deeply through the mouthpiece.
Medication form: The medication is a micronized dry powder, often containing an active ingredient and a carrier substance like lactose.
Patient Feedback: Users may not taste or feel the medication being inhaled, which can lead to uncertainty about whether the dose was received.
User Technique: It is crucial to inhale quickly and deeply to ensure the powder is properly aerosolized and delivered deep into the lungs.
No Propellant: This device does not use a pressurized propellant to expel the medication, making it CFC-free.
Cleaning: The device should never be washed with water. The mouthpiece can be wiped with a dry tissue.

Turbuhalers are commonly used for maintenance medications for conditions like asthma and COPD. Specific brand-name medications delivered via a Turbuhaler include Symbicort (budesonide/formoterol) and Pulmicort (budesonide),.

The Metered-Dose Inhaler (MDI): A Pressurized Spray

The Metered-Dose Inhaler, or MDI, is arguably the most recognizable type of inhaler. It is a small, handheld, pressurized canister that fits into a plastic actuator with a mouthpiece.

Key features and usage points of the MDI include:

Activation: The user presses down on the canister to release a measured dose of aerosolized medication.
Medication form: The medicine is suspended in a pressurized, liquid propellant (hydrofluoroalkane or HFA).
Patient Feedback: Users typically see and/or feel the spray, offering a sense of confirmation that a dose was released.
User Technique: The most significant challenge with MDIs is the timing, or coordination, required to press the canister and inhale slowly and deeply simultaneously.
Use with Spacers: For patients who struggle with coordination, a spacer device (a holding chamber) can be attached to the MDI to simplify the process and improve medication delivery.
Cleaning: MDIs often require weekly cleaning with warm water, with the canister removed from the plastic casing.

MDIs are used for both quick-relief (rescue) and long-term control medications. Examples include Albuterol (a rescue inhaler) and Advair HFA (a combination maintenance inhaler).

Comparison Table: Turbuhaler vs. MDI Inhaler


Feature	Turbuhaler (DPI)	Metered-Dose Inhaler (MDI)
Medication Type	Dry powder	Pressurized aerosol
Activation	Breath-activated	Manually pressed
Inhalation Speed	Requires a fast, deep breath	Requires a slow, steady breath
Coordination	Low-no coordination required	Requires timing between press and inhale
Propellant Used	No	Yes (HFA)
Use of Spacer	Not possible	Possible and often recommended
Patient Feedback	Little to no taste or sensation	Often a sensation of spray
Medication Type Examples	Budesonide (Pulmicort), Budesonide/Formoterol (Symbicort)	Albuterol (Ventolin HFA), Fluticasone/Salmeterol (Advair HFA)
Care Instructions	Wipe mouthpiece with a dry tissue	Wash plastic actuator with warm water

Which Device is Right for You?

The choice between a Turbuhaler (or other DPI) and an MDI depends on several factors, including your specific medication needs, personal preference, and ability to use the device correctly.

Turbuhaler Pros and Cons

Advantages:

Easier technique for some: The lack of required coordination makes it easier for many patients, especially the elderly or those with poor dexterity, to master the technique.
No Propellant: This is a benefit for those sensitive to propellants or who prefer a propellant-free delivery method.
Fewer Local Side Effects: For corticosteroid medications, some studies show a lower incidence of local side effects like thrush compared to MDIs.

Disadvantages:

Inspiratory Flow Dependent: Requires a strong, deep breath to effectively draw the medication into the lungs. Patients experiencing a severe asthma attack may not be able to generate enough force.
Perceived Underdosing: The lack of taste or feel can cause patients to worry they haven't received a dose, potentially leading to anxiety or improper use.

MDI Pros and Cons

Advantages:

Rescue and Maintenance Options: Many quick-relief rescue medications are available as MDIs, providing a necessary option during acute attacks.
Use with Spacer: The ability to use a spacer significantly reduces the need for perfect coordination, making it a viable option for many patients who struggle with technique.

Disadvantages:

Coordination Challenges: The need to press and inhale at the right moment can be difficult for many, especially children and the elderly, without a spacer.
High Risk of User Error: Due to the technique demands, incorrect usage is common and can lead to ineffective treatment.

Conclusion

The fundamental difference between Turbuhaler and inhaler types like MDIs lies in their mechanism of action: breath-activated dry powder versus manually actuated pressurized aerosol. While the Turbuhaler's simple, breath-driven technique makes it more user-friendly for many, it requires sufficient inspiratory force. In contrast, MDIs provide rescue options and can be improved with a spacer but pose more coordination challenges. Ultimately, the best device is the one a patient can use correctly and consistently to manage their respiratory condition. It is essential to receive proper training from a healthcare provider and to choose the device that best fits your needs. You can learn more about proper inhaler usage on the National Asthma Council Australia website.

Frequently Asked Questions

Neither is universally better; the best device depends on the individual patient's needs and ability. The Turbuhaler's breath-activated simplicity is advantageous for many, but MDIs offer a rescue option and can be used with a spacer to aid coordination,.

No, a spacer cannot be used with a Turbuhaler. Spacers are used to hold the pressurized aerosol from an MDI, and are not compatible with the dry powder mechanism of a Turbuhaler.

It is normal not to feel or taste the medication from a Turbuhaler because the dose is a very small amount of fine, dry powder. The small particle size is necessary for the medication to reach deep into the lungs.

If you do not inhale quickly and deeply enough with a Turbuhaler, the device will not effectively deliver the dry powder medication to your lungs, reducing its therapeutic effect. The powder may stick in your mouth or throat.

The most common and impactful mistake with an MDI is poor coordination between pressing the canister and inhaling. This can be mitigated by using a spacer, which makes the timing less critical.

A Turbuhaler has a dose counter window that indicates how many doses are left. Once the counter reaches zero, the inhaler is empty, even if you can hear a rattling noise. This noise is from a drying agent, not medication.

Turbuhalers are typically suitable for older children and adolescents who can follow instructions and produce a strong, deep, and rapid inhalation. For very young children or those who cannot, MDIs with a spacer and mask are often preferred,.