A comparative analysis of the particle size output of beclomethasone diproprionate, salmeterol xinafoate and fluticasone propionate metered dose inhalers used with the Babyhaler, Volumatic and Aerochamber spacer devices

Aims To determine in vitro the effect of delay, inspiratory flow, and space r washing on the drug output of metered dose inhalers (MDIs) used with diff erent spacer devices. Methods The amount of drug in particles <5 mu m diameter from MDI+spacer, s ampling after a delay of up to 20 s, was measured using a Multistage Liquid Impinger. Drug output was also measured at different flow rates, and after washing the Babyhaler in household detergent. Results More fluticasone in small particles was recovered from the Babyhale r than the Volumatic or the Aerochamber spacers, and more beclomethasone an d salmeterol was recovered from the Babyhaler and Volumatic spacers than fr om the Aerochamber. Washing the Babyhaler reduced the recovery of salmetero l, and did not alter the recovery of the other drugs tested. Conclusions Spacer devices need to be fully evaluated for each drug prescri bed for them.