Breztri Technique Masterclass: Priming, Inhaling, and Avoiding Common Mistakes

Breztri Technique Masterclass: Priming, Inhaling, and Avoiding Common Mistakes

If you’ve been prescribed Breztri Aerosphere for COPD, your inhaler technique matters just as much as the medication inside. Breztri delivers three medicines in one pressurized metered-dose inhaler (MDI), and small mistakes in how you prime, inhale, or clean it can mean less medicine reaches your lungs, and more ends up wasted.

This guide is your Breztri inhaler technique masterclass: we’ll walk through priming, inhalation style (MDI vs DPI), breath-hold timing, mouthpiece care, dose counter tips, and when to replace the canister. We’ll also touch on cost, including why many Americans now buy Breztri from Canada for about $197 per inhaler through Canadian prescription referral services like Over The Border Meds.

Breztri basics: what you’re using and how often

Before we dive into technique, a quick refresher:

  • What Breztri is: a combination inhaler containing budesonide (an inhaled steroid), glycopyrrolate (a LAMA), and formoterol (a LABA), used for maintenance treatment of COPD.
  • How often to use it: most patients are prescribed 2 puffs twice daily — usually morning and evening.
  • What type of inhaler it is: Breztri is a pressurized MDI, not a dry powder inhaler (DPI). That means it needs a slow, deep breath in, coordinated with a spray, not a fast, hard inhale like you’d use with a DPI.

Step-by-step: how to prime your Breztri inhaler correctly

You must prime Breztri before the first use so that each puff delivers the right amount of medicine. Priming uses a few “test sprays” that don’t count as doses for you to inhale. 

Before first use (new inhaler):

  • Shake the inhaler well.
  • Remove the mouthpiece cap.
  • Hold it upright, facing away from your face.
  • Press down on the middle of the dose indicator to release a spray into the air.
  • Repeat this until you’ve released 4 sprays, shaking before each spray.

After those 4 priming sprays, your Breztri inhaler is ready to use.

You’ll need to re-prime Breztri if:

  • It hasn’t been used for more than 7 days, or
  • It has been dropped, or
  • You’ve just cleaned the actuator with water and let it dry.

MDI vs DPI breathing: how to inhale Breztri the right way

Because Breztri is an MDI, your breathing should be slow and deep, not fast and forceful. Here’s the ideal Breztri inhaler technique for each puff:

  • Sit or stand up straight.
  • Shake the inhaler well and remove the cap.
  • Breathe out gently away from the mouthpiece — don’t blow into it.
  • Place the mouthpiece in your mouth and seal your lips around it, keeping your tongue low.
  • Start a slow, deep breath in through your mouth.
  • As you begin to inhale, press down firmly on the dose indicator once to release a puff.
  • Keep breathing in slowly and deeply until your lungs feel comfortably full.
  • Remove the inhaler and hold your breath for about 5–10 seconds, or as long as is comfortable.
  • Breathe out slowly through your nose or away from the inhaler.

Repeat the same steps for your second puff.

What about a spacer?

Breztri was designed to be used without a spacer, and official instructions don’t routinely include one. That said, if you:

  • Struggle to coordinate breathing and pressing, or
  • Have been told your technique isn’t great

Don’t forget the mouth rinse

Because Breztri contains an inhaled corticosteroid (budesonide), it can increase the risk of thrush (a fungal infection) in the mouth and throat if residue is left behind.

After you’ve taken both puffs:

  • Rinse your mouth with water,
  • Swish and gargle, then
  • Spit the water out — do not swallow it.

Making this a habit after every dose is a simple way to protect your mouth and throat.

Mouthpiece care: how to clean your Breztri inhaler

A clogged mouthpiece can ruin even perfect inhaler technique. Breztri’s actuator should be rinsed once a week to prevent medicine build-up.

Weekly cleaning routine:

  • Remove the canister from the yellow actuator and set it aside.
    • Important: do not wash or get the metal canister wet.
  • Take off the mouthpiece cap.
  • Hold the actuator under warm running water for about 30 seconds.
  • Turn it upside down and run warm water through it again for about 30 more seconds.
  • Shake off excess water gently.
  • Let the actuator air-dry completely (often overnight).
  • Once dry, gently press the canister back into the actuator and replace the cap.
  • Re-prime the inhaler by spraying 2 test puffs into the air, shaking before each.

Dose counter and when to replace your Breztri canister

 On the top of your Breztri canister, there’s a dose indicator that tells you roughly how many puffs you have left. 

Key points to know:

  • The pointer starts to the right of the highest number when full (e.g., a 120-dose canister).
  • The dose indicator moves in steps, usually every 10 puffs, rather than one-by-one.
  • As you approach the end of the inhaler, the background color changes to red in the window.
  • When the window shows “0”, the inhaler should be discarded — even if you feel or hear something when you shake it.

If you are using 2 puffs twice a day (4 puffs daily) and have a 120-puff canister, you’ll get about 30 days of regular use out of each inhaler (not counting priming sprays).

To avoid running out:

  • Check the dose counter once a week,
  • Plan your next refill when the indicator gets close to the red zone, and
  • Keep a backup inhaler if your prescriber recommends it.

Cost check: why some Americans buy Breztri from Canada

If you’re in the U.S., you’ve probably noticed that inhalers are expensive, and Breztri is no exception. Brand-name drugs tend to cost more in the U.S. because, unlike Canada, the U.S. historically hasn’t capped most drug prices at the national level.

Many patients now look to Canadian prescription referral services such as overthebordermeds to help them access Health Canada–approved Breztri at a lower price.

  • Americans can often buy Breztri from Canada for around $197 USD per inhaler, which can be significantly less than typical U.S. cash prices.
  • Services like Over The Border Meds connect U.S. patients (with a valid prescription) to licensed Canadian pharmacies, helping them stretch their COPD budget without sacrificing their maintenance therapy.

If cost is forcing you to stretch inhalers longer than prescribed or skip doses, talk to your healthcare provider and consider whether buying medications from Canada through a prescription referral service could make your treatment more affordable.

Dialing in your Breztri inhaler technique — priming correctly, inhaling in an MDI style (slow and deep), cleaning weekly, and watching the dose counter — can make your medication work better and help you get every bit of value out of each canister. And if high U.S. prices are stressing your budget, exploring Breztri from Canada through a Canadian prescription referral service like Over The Border Meds may help you stay on the treatment plan your prescriber intended.


Disclaimer: This article is for informational purposes only and not medical advice. Consult a licensed healthcare provider before starting or changing medications. Use reputable, licensed pharmacies to ensure safety. This guide is educational and doesn’t replace your clinician’s advice. Always follow the plan you and your healthcare team create for your specific situation.