Patient education: How to use your soft mist inhaler (adults) (The Basics)

What is a soft mist inhaler? — 

This is a device that releases a fine cloud of medicine that comes out more slowly than with other types of inhalers. Soft mist inhalers include ipratropium-albuterol (brand name: Combivent Respimat), olodaterol (brand name: Striverdi Respimat), tiotropium (brand name: Spiriva Respimat), and tiotropium-olodaterol (brand name: Stiolto Respimat).

How do soft mist inhalers work? — 

They spray a mist of medicine that you breathe in when you press down on a button on the side of the inhaler.

This article has instructions for how to use a soft mist inhaler. The instructions are different for other types of inhalers, such as metered dose inhalers or dry powder inhalers.

How do I get the inhaler ready? — 

Before you can start using the inhaler, you need to put in the cartridge. This is the part that contains the medicine. To do this:

●Keep the cap over the mouthpiece closed. Press the safety catch on the side of the inhaler. This releases the clear plastic base.

●Remove the clear plastic base.

●Write the "discard by" date on the label on the inhaler. This is 3 months from the date you put in the cartridge.

●Push the narrow end of the cartridge into the inhaler.

●Push on the cartridge to make sure it is in all the way. You can press it against a table top or other hard surface to do this. You will know the cartridge is in all the way when it "clicks" in place. You will still be able to see a little bit of the cartridge.

●Put the clear plastic base back on, and press until you hear a click.

●Once the cartridge is in the inhaler, do not remove it or the clear plastic base again.

Also, before you use your soft mist inhaler for the first time, you need to prepare it to release the right dose of medicine. This is called "priming."

How do I prime the inhaler? — 

To prime the inhaler before the first use, follow these 4 steps:

1. Hold the inhaler upright with the cap closed.

2. Twist the clear base to the right until it clicks (half a turn).

3. Open the cap by pushing on the small, round opening tab. Point the inhaler at the floor, away from your face.

4. Press the dose release button. Check to see if a mist comes out. Close the cap.

If you did not see a mist come out, repeat the 4 priming steps above until you do see a mist come out. Then, repeat these steps 3 more times until you see a total of 4 sprays of medicine. Your inhaler is now primed and ready for daily use.

If you do not use your inhaler for a while, follow these instructions before using it again:

●If you have not used your inhaler for longer than 3 days, do 1 "priming cycle" before using it. That means following the 4 steps above to release 1 spray of medicine.

●If you have not used your inhaler for longer than 3 weeks, do the priming steps and repeat them for a total of 4 sprays of medicine.

How do I use a soft mist inhaler? — 

Each inhaler comes with its own directions. Your doctor, nurse, or pharmacist will show you how to use yours. In general, these are the steps (figure 1):

●Hold the inhaler upright with 1 hand, with the cap closed.

●Use your other hand to turn the clear base half a turn in the direction of the arrows on the label until it clicks.

●Push up on the small, round opening tab until the cap is fully open.

●Breathe out slowly and completely.

●Put the mouthpiece in your mouth, holding the inhaler horizontally. It should be pointing toward the back of your throat.

●Close your lips around the mouthpiece, making sure not to cover the air vents (holes) on the sides.

●Take a slow deep breath in. At the same time, press the button on the side of the inhaler and breathe in the mist.

●When your lungs are full, hold your breath for 10 seconds to keep the medicine in your lungs.

●Take the inhaler out of your mouth, and breathe out slowly.

●Put the cap back on the mouthpiece.

Your doctor, nurse, or pharmacist will tell you how many sprays (puffs) of medicine to breathe in each day. You do not need to shake the inhaler.

How do I clean the inhaler? — 

Clean it once a week. Wipe the inside and outside of the mouthpiece with a clean, damp cloth.

How do I know when I need a new inhaler? — 

It is time for a new inhaler when the inhaler is empty or the discard date is reached.

Soft mist inhalers come with a built-in dose counter, also called a "dose indicator." This keeps track of how many doses are left in the inhaler. You can read the dose counter through the clear base. When the arrow is in the red zone, the inhaler is almost empty. When the counter reads 0 (zero), the inhaler has no more medicine in it.

When your inhaler is empty, throw it away and use a new one. Make sure you always have another inhaler available before you need it.

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