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Priming requirements for specific pressurized metered dose inhalers (pMDIs)

Priming requirements for specific pressurized metered dose inhalers (pMDIs)
Generic name US trade name Time to prime Number of sprays*
Short-acting bronchodilators
Albuterol (salbutamol) HFA ProAir HFA New and when not used for more than 2 weeks 3
Proventil HFA New and when not used for more than 2 weeks 4
Ventolin HFA New and when not used for more than 3 weeks or if dropped 4
Levalbuterol (levosalbutamol) HFA Xopenex HFA New and when not used for more than 3 days 4
Ipratropium bromide HFA Atrovent HFA New and when not used for more than 3 days 2
Ipratropium bromide and albuterol combination Combivent Respimat New and when not used for more than 3 weeks Repeated sprays toward ground until an aerosol cloud is visible; then repeat 3 more sprays
When not used for more than 3 days up to 3 weeks 1
Inhaled glucocorticoids
Beclomethasone HFA QVAR New and when not used for more than 10 days 2
Ciclesonide Alvesco New and when not used for more than 10 days 3
Fluticasone HFA Flovent HFA New 4
Not used more than 7 days or if dropped 1
Flunisolide HFA Aerospan New and when not used for more than 14 days 2
Combination glucocorticoid and LABA MDIs
Budesonide combined with formoterol Symbicort HFA New and when not used more than 7 days or if dropped 2
Fluticasone combined with salmeterol Advair HFA New 4
Not used more than 4 weeks or if dropped 2
Instructions for priming from approved product information in United States. Priming instructions for other pressurized meter-dose inhalers available in other countries may vary. Consult local product information.
HFA: hydrofluoroalkane; LABA: long-acting beta-agonist; MDI: meter-dose inhaler.
* Instruct patients to point the mouthpiece away from their face when releasing priming or test sprays into the air.
Data from: United States approved prescribing information available at US National Institute of Health DailyMed website https://dailymed.nlm.nih.gov/dailymed/ (accessed April 21, 2014).
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