📋 Sources: National Asthma Council Australia & Lung Foundation Australia — The Spirometry Handbook for Primary Care (2023) · NPS MedicineWise — The value of spirometry in clinical practice · ATS/ERS Standardization of Spirometry 2019 Update

What is spirometry?

Spirometry is the standard test for how well your lungs are working. You take a deep breath in, then blow out as hard and as fast as you can into a mouthpiece. The machine measures how much air you can breathe out and how fast. It is the main test used to diagnose and monitor asthma and COPD (emphysema/chronic bronchitis), and is sometimes used before surgery or to check work-related lung exposures.

The test is safe, painless, and usually takes 15–30 minutes.

What it involves, in short: you sit upright with a soft clip on your nose, take the biggest breath you can, then blow out as hard and fast as possible into a mouthpiece for 6–15 seconds. You'll repeat this 3 or more times, and sometimes again after a few puffs of Ventolin. No needles, no fasting — just some big breaths. Takes 15–30 minutes in total. Full details on inhalers and other prep below.
💊 Inhalers — the main thing to get right

If the test is being used to diagnose lung disease, or to see how much your reliever opens up your airways, you will usually be asked to stop your inhaler for a set time before the test. This is so the test shows your lungs in their baseline state.

Always check with the practice doing your test — they may give different instructions for your situation. Below are the typical withhold times.

Inhaler type Common brand names in Australia Withhold before test
Short-acting reliever (SABA) Ventolin, Asmol, Airomir (salbutamol); Bricanyl (terbutaline) 4–6 hours
Short-acting anticholinergic (SAMA) Atrovent (ipratropium) 12 hours
Long-acting reliever, twice-daily (LABA) Seretide, Symbicort, Foradile, Oxis, Serevent 24 hours
Long-acting reliever, once-daily (LABA) Breo (vilanterol) 36 hours
Long-acting anticholinergic (LAMA) Spiriva (tiotropium); Bretaris/Eklira (aclidinium); Seebri (glycopyrronium); Incruse (umeclidinium) 36–48 hours
Combined LABA + LAMA Anoro, Spiolto, Ultibro, Brimica, Bevespi, Trelegy 36–48 hours (follow the LAMA)
Inhaled corticosteroid (preventer) Flixotide, Pulmicort, Alvesco, Arnuity, Qvar Usually continue as normal
Theophylline tablets Nuelin SR 12–24 hours

Withhold times from the TSANZ / National Asthma Council Spirometry Handbook 2023 and ATS/ERS 2019 Standardization of Spirometry.

What if I really need my reliever? If you become short of breath, use your reliever as you normally would. Your safety comes first — just tell the person doing the test when you took it. They may reschedule or note it on the result.

Bring all your inhalers with you on the day — even the ones you have been asked to skip. The practice may want to:

✅ What you CAN do

Eat normally — spirometry is not a fasting test. A light meal is fine. Avoid a very heavy meal in the 2 hours before.
Drink water — normal hydration is fine.
Take your other regular medicines (blood pressure, cholesterol, etc.) as usual, unless told otherwise. Only inhalers and theophylline tablets need to be withheld.
Continue your preventer inhaler (inhaled corticosteroid like Flixotide, Pulmicort, Alvesco, Qvar) as normal.
Bring a list of all your inhalers — with the name, strength, and how often you use each one.

❌ What to AVOID

No smoking or vaping for at least 1 hour before (ideally 24 hours if the test is for COPD diagnosis).
No vigorous exercise in the 1 hour before.
No alcohol in the 8 hours before.
No large or heavy meal in the 2 hours before — a full stomach can make it harder to take a deep breath.
No tight clothing around your chest, waist, or neck (tight belts, corsets, restrictive bras, neckties).

What happens on the day
  1. The clinician will measure your height and weight — these are needed to interpret the result.
  2. You sit upright in a chair. A soft clip is placed on your nose so all the air goes through your mouth.
  3. You take the biggest, deepest breath you can, seal your lips around the mouthpiece, then blow out as hard and as fast as you can and keep blowing until your lungs feel completely empty — this can take 6–15 seconds.
  4. You will repeat the test 3 or more times to make sure the results are consistent.
  5. If a post-bronchodilator test is needed, you will be given a few puffs of Ventolin via a spacer, wait 15 minutes, then repeat the test.

The test is not painful. You may feel a little light-headed for a few seconds afterwards — this is normal and passes quickly. Some people cough.

⚠️ When to reschedule the test

Phone the practice and reschedule if any of the following apply:

  • A chest infection, cold, flu, or COVID in the last 2–4 weeks (spirometry results can be wrong if airways are inflamed)
  • Recent chest, abdominal or eye surgery (typically within the last 4 weeks)
  • Recent heart attack or unstable chest pain
  • You are coughing up blood
  • You have an active tuberculosis (TB) infection
  • You feel severely unwell on the day
Common questions

Can I have a coffee on the morning of my spirometry?

There is no strict rule against coffee for a standard spirometry test, but some practices ask you to skip caffeine for a few hours because it can mildly affect the airways. If unsure, ask the practice doing your test.

I forgot and used my Ventolin this morning — should I cancel?

Don’t cancel — phone the practice and tell them. Most can either go ahead and note it on your result, or shift the appointment by a few hours so the reliever wears off.

Do I have to stop my preventer inhaler too?

Usually no. Inhaled corticosteroid preventers (Flixotide, Pulmicort, Alvesco, Arnuity, Qvar) are continued as normal — they do not affect the immediate spirometry result. If your inhaler is a combination (preventer plus long-acting reliever like Seretide, Symbicort, or Breo), follow the long-acting reliever rule (24 hours).

Does spirometry cost anything?

If done at a bulk-billing GP practice, usually no out-of-pocket cost. Some practices charge a private fee for the spirometry test itself, separate from the GP consultation. Ask the practice when you book.

General guide only. Always follow the specific instructions from the practice doing your test — different machines, indications, and clinical situations can change the prep. If you are short of breath, use your reliever inhaler as normal and tell the clinician when you arrive.