This device is called a Flexhaler. It is a breath-activated device, which means the medication is released when you inhale.

Before you use the Flexhaler for the very 1st time, you will need to prime it. To prime the Flexhaler, twist off the cap and hold the device straight up.

Turn the brown bottom to the right and then to the left. You will hear a click. Now, repeat this step. Turn the brown bottom to the right and then to the left. You will hear a click.

You do not have to prime the Flexhaler any other time.

When you are ready to take your medication, you will need to load your medication. To load the medication, hold the Flexhaler up straight. Turn the brown bottom to the right and then back to the left and you will hear a click. The medication is now loaded and ready for you to take.

Once the medication is loaded, you will need to keep the Flexhaler steady. Do not shake it or cough or breathe into it or you will lose some of the medication.

To take your medication, turn away from the mouthpiece and breathe out. Then carefully bring the Flexhaler to your mouth and seal your lips tightly around the mouthpiece. Breathe in rapidly and deeply and hold your breath for as long as you can up to 10 seconds.

Repeat for each dose you have been told to take.

Always rinse your mouth with water and spit it out after using the Flexhaler.

The Flexhaler has a dose counter window below the mouthpiece. It will let you know approximately how many doses are left. When the device is full, you will either see the number 120 or 60 at the center of the window, depending on your prescription. As you use the Flexhaler, you will notice that the numbers will decrease by 10, alternating numbers and dashes going down to 0. For example, if your Flexhaler starts at 120, after 10 doses, you will see a dash in the middle of the window. After 10 more doses, you will see the number 100. After 10 more doses you will see a dash for 90 doses remaining. The Flexhaler will count down to 0 in the center of the window when the Flexhaler is empty.

When the Flexhaler is empty, you may still hear a sound if you shake the device, but it is not the medicate, it is the drying agent that keeps the medication dry.

To clean the Flexhaler, do not put it in water. Simply wipe the mouthpiece with a clean cloth when it appears dirty or at least every week. And then, be sure to keep the cap on the Flexhaler after each use to help it stay clean.

National Jewish Health has been ranked by US News and World Report as the number one respiratory hospital in the nation for 11 years in a row. Find out more at