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Technique for use of a pressurized metered dose inhaler (MDI) without a spacer or chamber

Technique for use of a pressurized metered dose inhaler (MDI) without a spacer or chamber
Remove the cover of the mouthpiece.
Prime your inhaler if this is the first time you are using it, if you have not used it for several days, or if you have dropped it. Priming an MDI usually involves shaking it and spraying it into the air (away from your face) a total of up to 4 times. See the information that came with your inhaler for exact instructions.
Shake MDI canister vigorously for 5 seconds.
Hold the MDI upright with your index finger on the top of the medication canister and your thumb supporting the bottom of the inhaler.
Breathe out normally.
Put the mouthpiece between your teeth and close your lips around mouthpiece or position mouthpiece approximately 4 cm (approximately width of 2 fingers) from your mouth.
Keep your tongue away from the opening of the mouthpiece.
Press down the top of the canister with the index finger to release the medication.
At the same time as the canister is pressed, breathe in deeply and slowly through your mouth until your lungs are completely filled; this should take 4 to 6 seconds.
Hold the medication in your lungs for as long as comfortable (approximately 5 to 10 seconds) before breathing out.
If you need a second puff, wait approximately 15 to 30 seconds between puffs. Shake canister again before the next puff.
When finished, recap mouthpiece.
If your inhaler contains a steroid medicine (sometimes called glucocorticoid or corticosteroid), rinse your mouth and gargle with water after you use it. Then spit out the water. Do not swallow it.

We prefer to use metered dose inhalers (MDIs) with a spacer or holding chamber. Instructions for use of MDIs with these devices is provided in a separate graphic.

These instructions do not apply to dry powder or soft mist inhalers. Cleaning instructions are provided separately.

More detailed information about individual medication formulations can be found at http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm.
Graphic 103302 Version 8.0

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