Table 1 Advantages and disadvantages of breath-triggered inhalers (BTIs)

Main advantage over pressurized metered dose inhalers (pMDIs)

 There is no need to coordinate inhalation and actuation, since the device is self-triggered by the patient’s inspiratory flow.

Main advantage over dry powder inhalers (DPIs)

 BTIs release the drug at low inspiratory flow. Therefore, patients do not need to inhale forcibly. Furthermore, drugs’ impact on upper airways is reduced.

Further advantages of k-haler BTIs

 The device is small, light and portable.

 The device allows multiple doses, without any charging.

 It has got a dose counter, so that patients know how many doses are left.

 Few steps are needed to prime and operate the device, making it simple to use.

 Audible “clicks” when priming and closing allow feedback that the device is ready to use or store, respectively.

 The automatic release of a dose when the mouthpiece cap is closed prevents double or multiple doses if a primed dose is not taken.

 The closed canister avoids contents’ contamination.

 The cap is connected to the device, therefore it cannot be lost.

 There is high reproducibility in the amount of drug delivered.

Main disadvantages

 BTIs are available for a limited range of drugs.

 If there is a suspension enclosed, patients need to remember to shake the device before each use.

 BTIs need priming before first use, in case of cold environment or if not used for some time.