Hi Alice, my pulmo's instructions are to use as needed every 4-6 hours, up to 4 times a day, for both the nebulizer and my puffers. Exceptions being maintenance meds Ohtuvarye and Breztri, twice a day. Most days I need to use mine (albuterol or duoneb) 2-3 times a day at 4-5 hours. I hope this helps. It works for me. It can be so confusing sometimes. Contact your doctor, they are the experts, you don't want to use too much, nor deprive yourself of treatment when needed! There are NO dumb questions!!! Hope you can get some clarity on this important question.

Yes Alice, I'm also using the nebulizer on an as-needed basis. It really does help on those tough days. But seriously, my worst breathing problem is my anxiety. If only I could get that under control....Anyway, I hate sitting still to use then nebulizer and it makes me really anxious. Easier to just use the albuterol inhaler (Ventolin) as needed for me.

Hello again Alice, Yes I do now.
Last year when I was having troubles with SOB I was upped from 4 times a day to 6 times a day. That is the most they prescribe for the nebulizer. Since waking up at night just to do it bothered me I started cutting back. Then after my heart issue was cleared up didn't need it as much and cut back to 3 or 4 times a day. As I have improved with my exercises I have cut it back to 2 times a day. So my pulmonologist changed the order from 6X a day to "as needed".
I asked why and he said if I go into the hospital they would give it to me every 4 hours if the order was 6x a day. So best to be as needed, then I could do two or even 3 times a day if needed and can order my refills accordingly. That way I can adjust the medicine deliveries accordingly.
Hope that helps and explains it. I kind of like it so when I am feeling bad I can do it more.

yes I do, there's nothing wrong with using it, as and when you need it, provided it is not a strong inhaler, else rinse your mouth out soon after use.

Good afternoon AliceRose, "as needed" now that's one that is just what it is, I'm in that same category, I've been on albuterol (nebulizer) since I've been diagnosed with COPD (2018) 4 times a day, every 6 hours this is what my pulmonologist prescribed me, my inhaler same thing, so for me that "as needed" if he tells you that then follow his direction everyone is different I guess for me 6 years in I use it as needed especially in the mornings thats when I needed most. If I need a treatment during the course of the day, I take one. I hope this helps take care and breathe easy😆