Best practice is to use a spacer
Carton Doubles As
A Spacer…
As stated by GINA (Global Initiative for Asthma), use of a spacer improves delivery and with an Inhaled Corticosteroid (ICS) reduces the potential for side-effects.
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- In emergencies
- With better medicine delivery
- Reduced side effects
- Compliance with best practice
- Reduced additional costs
Know More About the MDI Plus Spacer.
Published Articles
Practical Strategies to Improve Asthma Control in Resource-Limited Settings
Haitham Saeed, Hasnaa Osama, Basma M.E. Mohamed, Wesam G. Ammari and Mohamed E.A. Abdelrahim
Evaluation of a cardboard-based spacer for enhancing aerosol delivery from pressurized metered dose inhalers
MDI Plus – Innovation and Simplicity
What are Spacers?
Spacers, also known as holding chambers or inhaler chambers, are add-on devices used with pressurised metered-dose inhalers (pMDIs) to enhance medication delivery and coordination during inhalation.
These devices, commonly made of plastic, act as an intermediate chamber that holds the medication released from the pMDI, allowing patients to inhale at their own pace and facilitating more of the drug reaching the lungs.
MDI Manufacturer Benefits
Low-cost Primary Pack Spacer
Sustainability
Best Practice
Marketing Opportunities
User-Friendly Design
Durable Performance
Improved Lung Deposition
Anti-Counterfeiting
Behind the scenes
The Innovation
There are approx. 3.2 million deaths due to chronic obstructive pulmonary disease (COPD) and 495,000 deaths due to asthma, according to the 2017 Global Burden of Diseases Study (GBD). Many millions more suffer from these diseases and would benefit from better drug delivery to the lungs, with the use of a spacer.
MDI Plus Ltd. is striving to alleviate this suffering and improve Patient’s lives, through this simple innovative solution.
Like all good innovations the simple ones are the best. MDI Plus Ltd. discovered a solution to improve pMDI delivery and compliance. We carried out multiple, In-vivo and In-vitro tests and have now proved the hypothesis.
The MDI Plus spacer is equivalent to the market leading plastic spacer and is superior to using a pMDI alone.
These results left us in no doubt that MDI Plus was a game changer for developing regions and also use in emergency situations.
Benefit your customers and enhance your product marketing with this innovative solution.
Improve Sustainability with MDI Plus.
Our Solution and its Results Compared
Lung Deposition
Ease of Use
Robustness
Lung Deposition
- In-vitro equivalence to market leading plastic spacer.
- In-vivo superiority to pMDI alone (and equivalence to market leading spacer)
- Good in-use patient acceptability.
Summary of aerosol properties
| Mean Value (n=3) | MDI (alone) | AeroChamber | MDI Plus |
| Fine Particle Dose [µg] | 91.47 | 130.33 | 126.74 |
| MMAD [um] | 4.15 | 4.22 | 3.88 |
| GSD | 1.63 | 1.48 | 1.37 |
Ease of Use
When testing the easiness of the use of MDI(alone) with MDI Plus compared to MDI with Aerochamber and MDI alone we found that MDI with MDI Plus required a lower number of sessions to use it correctly, have a lower number of correctly used steps mistakes compared to MDI with Aerochamber and MDI alone.
Number of sessions to correctly use of MDI and MDI with spacers (n=20)
| MDI(alone) | Aerochamber | MDI Plus | |
| Mean (SD) | 2.15 (0.99) | 2.05 (0.83) | 1.05 (0.69) |
| Median | 2 | 2 | 1 |
| Total number of mistakes | 104 | 135 | 19 |
Robustness
The MDI Plus was shown to deliver a similar amount of aerosol with similar properties after 20 and 50 uses.
Following extensive tests, the MDI Plus spacer was shown to continue to provide, improved performance, against using a measured dose inhaler alone.
Lung Deposition
- In-vitro equivalence to market leading plastic spacer.
- In-vivo superiority to pMDI alone (and equivalence to market leading spacer)
- Good in-use patient acceptability.
Summary of aerosol properties
| Mean Value (n=3) | MDI (alone) | AeroChamber | MDI Plus |
| Fine Particle Dose [µg] | 91.47 | 130.33 | 126.74 |
| MMAD [um] | 4.15 | 4.22 | 3.88 |
| GSD | 1.63 | 1.48 | 1.37 |
Ease of Use
Ease of Use
When testing the easiness of the use of MDI(alone) with MDI Plus compared to MDI with Aerochamber and MDI alone we found that MDI with MDI Plus required a lower number of sessions to use it correctly, have a lower number of correctly used steps mistakes compared to MDI with Aerochamber and MDI alone.
Number of sessions to correctly use of MDI and MDI with spacers (n=20)
| MDI(alone) | Aerochamber | MDI Plus | |
| Mean (SD) | 2.15 (0.99) | 2.05 (0.83) | 1.05 (0.69) |
| Median | 2 | 2 | 1 |
| Total number of mistakes | 104 | 135 | 19 |
Robustness
Following extensive tests, the MDI Plus spacer was shown to continue to provide, improved performance, against using a measured dose inhaler alone.
MDI Plus Patient Benefits
Improved Medication Deposition
Reduced Systemic Side Effects
Cost-Effectiveness
Sustainable
Best Practice
Storage
How to use MDI Plus Carton / Box Spacer
Step by Step Instructions:
- Open Inhaler carton at the top end of the carton, breaking seal/perforations, if it’s a new pack.
- Remove Inhaler and Patient Information Leaflet.
- Remove protective mouthpiece cap and check there is nothing inside spacer or box.
- Shake the MDI and insert into the end of the carton.
- Breath out as far as comfortable.
- With the carton closed, bring spacer up to mouth.
- Depress the inhaler to release the dose at the start of inhalation.
- Maintain a slow inhalation rate until the lungs are full.
- Lower spacer from the mouth and breathe hold for 5-10 seconds.
- If more than one dose is required, wait about 30 seconds, before the next dose.
- Replace Cap and store back in box / carton, in your jacket, bag or briefcase.
- MDI Plus box can be used 50+ times.
About Us
David Little
MDI Plus Ltd. – Managing Director
Print and Packaging Technologist and Independent Packaging Consultant
David has over 35 years’ experience, covering all packaging substrates, including cartons, corrugate, flexible film laminates, rigid plastics, labels and all printing and conversion processes. He is also experienced in Packaging Consultancy & Training, Sales & Marketing, New Product Development, Brand Management, Repro and Capital Equipment.
He has worked across all sectors, including Food & Drink, Pharmaceutical, IT, and Industrial.
David holds the following positions:
- Managing Director of Leonard Little & Associates Ltd. www.leonardlittleassociates.com.
- Chair of the Irish Packaging Society.
- Board Member of ‘IOM3 – The Packaging Society’ (UK).
- Course Director for multiple packaging training courses
- Lecturer in Print & Packaging Technology in Ireland, UK and EU.
- Fellow of the Institute of Materials, Minerals and Mining (IOM3).
Dr. Mohamed EA Abdelrahim
MDI Plus Ltd. – Director of Innovation
Received his PhD from Bradford University, Bradford, UK in 2009 in aerosol therapy. He is listed in the Sanford list of best researchers in the world since 2019 to the present day.
Mohamed has written over 200 published papers and over 80 conference presentations most of them in aerosol therapy. His main area of expertise is Clinical pharmacy and
aerosol
Get In Touch
How to Obtain A License
Our Intellectual Property is currently Patent Pending.
There is room within the IP for manufacturers to personalise the design, board, coatings or tamper evident aspects of the pack or holder.