TECHNIQUE FOR USE OF METERED DOSE INHALAR (MDI)

Shake canister vigorously for 5 seconds.
Uncap mouthpiece and check for loose objects in the device.
Insert MDI into spacer. Hold the MDI upright with the index finger on the top of the medication canister and the thumb supporting the bottom of the inhaler. You may need to use the other hand to hold the spacer.
Breathe out normally.
Close lips around spacer. For spacers that have a mask, hold the mask snugly to the face. If no spacer is available, close lips around mouthpiece or position it about 4 cm from the mouth.
Keep tongue away from the spacer opening or mouthpiece.
Press down the top of the medication canister with the index finger to release the medication.
At the same time as the canister is pressed, inhale deeply and slowly through the mouth until the lungs are completely filled; this should take four to six seconds.
Hold the medication in the lungs as long as possible (4 to 10) seconds before exhaling. If using a spacer, you may inhale a second time and hold the breath if needed.
If a second puff is needed, wait approximately 15 to 30 seconds between puffs, or long enough to perform the next inhalation properly. Shake canister again before use.
Recap mouthpiece.
These instructions do NOT apply to dry powder inhalers. Cleaning instructions are provided separately.