| 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 a metered dose inhaler usually involves shaking it and spraying it into the air (away from your face) up to 4 times. See the information that came with your inhaler for exact instructions. |
| Check the number of doses remaining in the MDI. |
| Sit or stand up straight with the chi tilted up and neck slightly extended. |
| Shake MDI canister vigorously for 5 seconds. |
| Hold the MDI upright with your index finger on the top of the 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 about 4 cm (about the 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 medicine. |
| At the same time as the canister is pressed, breathe in deeply and slowly through your mouth until your lungs are completely full. This should take 3 to 5 seconds. |
| Hold the medicine in your lungs for as long as comfortable (about 5 to 10 seconds). |
| Remove the inhaler from your mouth and exhale normally. |
| If you need a second puff, wait about 15 to 30 seconds between puffs. Shake the canister again before the next puff. |
| When finished, put the mouthpiece cover back on. |
| If your inhaler contains a steroid medicine (sometimes called a "glucocorticoid" or "corticosteroid"), rinse your mouth and gargle with water after you use it. Then spit out the water. Do not swallow it. |
These instructions do not apply to dry powder or soft mist inhalers. Cleaning instructions are provided separately.
More detailed information about individual medicines can be found at http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm.