Dry Powder Medication

Dry powder inhalers (DPIs) provide medicine in powder form. Like a metered dose inhaler, a precisely measured dose of medicine is delivered. A DPR is breath-activated, so you breathe in the dry powder as you take a breath. As with all inhalers, proper use and following instructions is necessary.

Types of Dry Powder Medication and Instructions for Use

Pulmicort Flexhaler ™  |  Foradil ® Aerolizer Inhaler  |  Spiriva® Handihaler®  |  Asmanex ® Twisthaler®

Pulmicort Flexhaler ™

Priming Your Inhaler:
Before you use a new Pulmicort Flexhaler™ for the first time, you should prime it.

1. Hold the Flexhaler™ so the white cover points up.
2. Grab the Flexhaler™ by the brown grip in one hand and with the other hand, turn the white cover and lift it off.
3. Hold the Flexhaler™ with the mouthpiece facing up in one hand. Using the thumb and index finger of your other hand, grab the inhaler in the middle. Do NOT hold the inhaler at the top of the mouthpiece.
4. Twist the brown grip as far as it will go in one direction and then fully back again in the other direction until it stops. It does not matter which way you turn it first. You will hear a click during one of the twisting motions.
5. Repeat step 4. Your Flexhaler™ is now primed.

You do not have to prime it again after this, even if you put it aside for a prolonged period of time.

Loading a Dose:

1. Twist the cover and lift off.
2. Hold the Flexhaler with mouthpiece pointing up to load the medicine correctly into the chamber. DO NOT hold the mouthpiece when you load the inhaler.
3. Twist the brown grip fully in one direction as far as it will go. Twist it back again fully in the other direction as far as it will go. It does not matter which way you go first.
4. Twist the cover and lift off.
5. Hold the Flexhaler with mouthpiece pointing up to load the medicine correctly into the chamber. DO NOT hold the mouthpiece when you load the inhaler.
6. Twist the brown grip fully in one direction as far as it will go. Twist it back again fully in the other direction as far as it will go. It does not matter which way you go first.

Pulmicort Flexhaler™ is designed to deliver only one dose at a time, no matter how often you click the brown grip. The dose indicator will continue to advance though. If you accidentally blow into your inhaler after loading a dose and before you breathe in the dose, load a new dose.

Inhaling the Dose:

1. Turn your head away from the Flexhaler™ and breathe out as much air as you can. Do not shake and do not blow or breathe into the Flexhaler™ after loading it.
2. Hold the Flexhaler™ in the horizontal (on its side) position. Place the mouthpiece between your lips and breathe in deeply and forcefully through your mouth
3. Remove the mouthpiece from your mouth. Breathe out slowly. DO NOT blow or breathe into the mouthpiece.
4. If more than one dose is required repeat the steps.
5. When you are finished, place the cover back on the Flexhaler™ and twist it shut.
6. Rinse your mouth with water. Do not swallow.

Tips

• Keep your Pulmicort Flexhaler™ clean and dry at all times.
• You may not taste, smell or feel the medication but this does not mean you did not get the medication.
• Do not bite or chew on the mouthpiece.

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Foradil ® Aerolizer Inhaler

1. Pull the cap off the inhaler.


2. To open, hold the base of the inhaler firmly and turn the mouthpiece in the direction of the arrow.


3. Remove the capsule of powdered medicine from the blister pack. Do not remove the capsule from the pack until you are ready to use it.


4. Place the capsule in the capsule shaped compartment in the base of the inhaler.


5. Move the mouthpiece to the closed position.


6. Keep the inhaler upright and firmly squeeze the two blue buttons fully ONE TIME ONLY. This will make a hole in the powder capsule. Even though the capsule is now ready, the powder will not be released until you breath it in.


7. Turn your head away from the Aerolizer and breathe out completely.


8. Put the mouthpiece between your lips and tilt your head slightly back. Close your lips around the mouthpiece and breathe in quickly and deeply. You should hear a "whirring" noise when you breathe in because the capsule spins around in the inhaler.


9. Hold your breath for approximately 10 seconds, and remove the inhaler from your mouth.


10. Turn your head away from the Aerolizer and breathe out slowly.


11. Open the inhaler and check that the capsule is empty. If it is not empty, close the inhaler and repeat steps 7 to 10.


12. Remove the empty capsule, close the mouthpiece and replace the cap to store until the next dose.

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Spiriva® Handihaler®

1. Open the dust cap by pressing the green piercing button.


2. Pull the cap up, exposing the mouthpiece.


3. Open the mouthpiece by pulling it upwards.


4. Separate one of the blisters from the blister case by tearing along the perforation. Remove the capsule from foil blister.


5. Place the capsule in the center chamber of the HandiHaler®.


6. Close the mouthpiece until a click is heard.


7. Hold the HandiHaler® with the mouthpiece facing up and press the green piercing button in until it is flush against the base. This makes the holes in the capsule and allows the medicine to be released when you breathe in.


8. Turn your head away from the HandiHaler® and breathe out completely Do not breathe into HandiHaler®.


9. Holding the HandiHaler by the gray base, place the mouthpiece in your mouth and close your lips tightly around the mouthpiece.


10. Breathe in slowly and deeply. You should hear or feel the capsule vibrate. Hold your breath for approximately 10 seconds as you remove the HandiHaler from your mouth. Do not breathe into the HandiHaler.


11. If you do not hear or feel the capsule vibrate, or if any powder remains in capsule, repeat steps 8 through 10.


12. Open the mouthpiece and throw away empty capsule. Do not store capsule in inhaler.


13. Close the mouthpiece and dust cap to store until next dose.

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Asmanex ® Twisthaler®

1. Hold the inhaler pointing up, with the pink base on the bottom.


2. Hold the base and twist the white cap counterclockwise while keeping the inhaler pointing up and lift the cap off. The dose counter counts down by one when the cap is lifted off. Removing the cap loads the TWISTHALER® with the medicine.


3. Before inhaling your ASMANEX®, turn your head away from the TWISTHALER® and breathe out as much air as you can. Do not breathe out into the inhaler.


4. Looking straight ahead, hold the TWISTHALER® in the horizontal position (on its side) and place the mouthpiece in your mouth. Close your lips around the mouthpiece. Take a fast, deep breath. Do not cover the ventilation holes while breathing in the medicine.


5. Remove the inhaler from your mouth and hold your breath for about 10 seconds or as long as you comfortably can. Do not breathe out into the inhaler.


6. After you take your medicine wipe the mouthpiece dry. It is important to protect the inhaler from moisture.


7. Check to make sure that the arrow is lined up with the dose counter.


8. Replace the cap right away and twist it clockwise until it clicks (this is the only way to be sure that your next dose is properly loaded).

Repeat the above steps every time you take a dose. Rinse your mouth after using.

Tips

• ASMANEX® TWISTHALER® has a dose counter on the base. It shows the number of doses left to use. When the unit reaches “01” it means that is the last dose. After you take that dose the counter will read “00” and you will have no more doses.


• Discard the inhaler 45 days after opening the pouch or when the dose counter reads "00," whichever comes first.


• You may not be able to taste, smell or feel the medicine after you breathe in since it is a very fine powder.

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