When and How to Use a Nebulizer (2024)

There are many ways to take medication, but inhaled treatments are the most direct way to get to the lungs. If you have a chronic (long-term) respiratory condition like asthma or chronic obstructive pulmonary disease (COPD)—or even an acute (short-term) illness like bronchitis—you may be prescribed a nebulizer. These devices provide aerosolized treatments, which turn liquid medication into an inhaled mist, delivering high concentrations of medication directly to the lungs.

This article will explore what conditions you would use a nebulizer for, what medications you may use, and how to perform these treatments at home.

Purpose of Nebulizer Treatment

A nebulizer is a machine that transforms medication into a fine mist, delivering it into your bronchial and lung tissues through inhalation through a handheld device or mask. When inhaled, the mist from the nebulizer can provide high concentrations of medication directly to your airway.

Healthcare providers prescribe nebulizers to treat various chronic and acute respiratory conditions, including:

• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Cystic fibrosis
• Bronchiectasis

Nebulizers are often the go-to respiratory treatment option for infants, young children, or anyone else who may have difficulty using an inhaler because they don't require you to breathe as deeply as inhalers do to benefit from treatment.

Nebulized treatments are valuable because they:

• Are easy for your body to absorb and use
• Reduce the systemic effects of steroids and other medications compared to oral routes
• Require very little cooperation or coordination to use
• Work quickly
  

Nebulizer Machine Parts and Instructions

Nebulizers come in different models but generally include the following parts:

• The main machine, including an air compressor
• A medication cup with a cap
• A mask or mouthpiece
• Tubing that runs from the mask or mouthpiece to the air compressor

Typically, you need an electrical source to plug the nebulizer into; however, some use batteries. To use the nebulizer, first ensure your hands and the machine components are clean, then follow the steps below.

1. Pour the prescribed medication into your medication cup.
2. Attach the cap to the cup.
3. Attach your mask or mouthpiece to the medicine cup.
4. Connect the mask or mouthpiece to the compressor with the supplied tubing.
5. Turn on the compressor and hold the mask or mouthpiece upright. A fine mist should start to emerge from the mask or mouthpiece.
6. Bring the mask or mouthpiece to your face and breathe in normally.
7. Continue breathing through the mask or mouthpiece until the medication cup is empty.
8. When you finish the treatment, follow the manufacturer's instructions on your device to clean and store it for the next use.
   

How to Get a Nebulizer Prescribed

Although you can buy a nebulizer on your own, Medicare and private health insurance plans require you to have a prescription explaining why you need a nebulizer.

Even if you purchase a nebulizer on your own, you will need a prescription from your healthcare provider for the medications used in the machine.

Medications commonly used in nebulizers include:

• Corticosteroids like Symbicort (budesonide and fluticasone)
• Bronchodilators like Proventil HFA (albuterol)
• Long-acting bronchodilators like Serevent Diskus (salmeterol) and Perforomist (formoterol)
• Anticholinergics like Spiriva Respimat (tiotropium bromide)

If you see a pulmonologist or another respiratory specialist for asthma, cystic fibrosis, or another chronic respiratory condition, they can prescribe and help you manage your nebulizer and medications.

A healthcare provider may prescribe a nebulizer to treat acute conditions involving inflammation or wheezing—not necessarily a cough.

Cost of Parts

With some limitations, Medicare and Medicaid cover the cost of a nebulizer and its accessories. Nebulizers are considered durable medical equipment (DME) and are covered when prescribed by a healthcare provider for a valid condition.

There may be some stipulation on the style and model of the nebulizer that Medicare and Medicaid cover. Basic models are often covered, but models with extras for convenience may not be fully covered. If you have private health insurance, your health plan usually covers at least a portion of the cost of a prescribed nebulizer. It's a good idea to call your insurer for a list of covered models or any restrictions before ordering your device.

With Medicare and Medicaid, you may have some co-payment or deductible to meet—usually around 20% once you have met your deductible—and out-of-pocket costs will vary between private insurers.

Chemicals and devices used to clean nebulizers aren't usually covered, but your prescription drug plan will cover the medication you use in your nebulizer.

Nebulizer Machine Maintenance

After each use, clean nebulizer attachments like masks, mouthpieces, tubing, and medicine cups in warm, soapy water or on the top rack of your dishwasher. Do not submerge the tubing in water; instead, wipe it down.

In addition to cleaning after each use, you should deep-clean your equipment once a week by soaking the attachments (minus the tubing) in a mixture of vinegar and water for 30 minutes.

After washing or deep cleaning your nebulizer attachments, let them air-dry thoroughly before the next use. Like the tubing, you should also wipe down the air compressor; never submerge it in water. You may also need to replace an air filter in your compressor based on manufacturer recommendations.

You may need to replace your nebulizer and accessories over time, though the timeline varies by manufacturer. Medicare, Medicaid, or your health insurance company may also have rules on how often they cover replacements.

Summary

Nebulizers are valuable tools for people with acute and chronic respiratory conditions. They turn liquid medications into fine mists that can quickly and effectively relieve lung symptoms.

Most public and private healthcare plans cover at least a portion of a nebulizer, but you will need a prescription from your healthcare provider to take advantage of this benefit. Some plans may reimburse you if you purchase a device on your own, but coverage may still depend on the limits of your prescription and insurance plan.