Flutiform Caution For Usage

To ensure proper administration of the drug, the patient should be shown how to use the inhaler correctly by a physician or other health professionals. The correct use of the pressurised metered dose inhaler (pMDI) is essential for successful treatment. The patient should be advised to read the Patient Information Leaflet carefully and follow the instructions for use and pictograms in the leaflet.
The actuator has an integrated counter which counts down the number of actuations (puffs) remaining. This counter is also colour coded. It starts off green then, when there are less than 50 puffs (actuations) left it changes to yellow and when there are less than 30 puffs (actuations) left it changes to red. The counter counts down from 120 to 60 in intervals of 10, and from 60 to 0 in intervals of 5. When this is getting near to zero the patient should be advised to contact their prescriber for a replacement inhaler. The inhaler must not be used after the dose indicator reads "0".
Priming the inhaler: Before using the inhaler for the first time, or if the inhaler has not been used for 3 days or more, or after exposure to freezing or refrigerated conditions (see Storage) the inhaler must be primed before use: Remove the mouthpiece cover and shake the inhaler well.
Actuate (puff) the inhaler whilst pointing it away from the face. This step must be performed 4 times.
The inhaler should always be shaken immediately before use.
Whenever possible patients should stand or sit in an upright position when inhaling from the inhaler.
Steps to follow when using the inhaler: 1. Remove the mouthpiece cover and check that the mouthpiece is clean, and free from dust and dirt.
2. The inhaler should be shaken immediately before releasing each actuation (puff) to ensure that the contents of the inhaler are evenly mixed.
3. Breathe out as far as is comfortable and as slowly and deeply as possible.
4. Hold the canister vertically with its body upwards and put the lips around the mouthpiece. Hold the inhaler upright with a thumb(s) on the base of the mouthpiece and a forefinger/index finger(s) on the top of the inhaler. Do not bite the mouthpiece.
5. Breathe in slowly and deeply through the mouth. After starting to breathe in press down on the top of the inhaler to release one actuation (puff) and continue to breathe in steadily and deeply (optimally for about 2-3 seconds for children and 4-5 seconds in adults).
6. While holding breath, remove the inhaler from mouth. Patients should continue to hold their breath for as long as is comfortable. Do not breathe out into the inhaler.
7. For the second actuation (puff), keep the inhaler in a vertical position then repeat steps 2 to 6.
8. After use, replace the mouthpiece cover.
IMPORTANT: Do not perform steps 2 to 6 too quickly.
Patients may be advised to practise their technique in front of a mirror. If a mist appears following inhalation, either from the inhaler or from the sides of the mouth, the procedure should be repeated from step 2.
For patients with weak hands, it may be easier to hold the inhaler with both hands. Therefore the index fingers should be placed on the top of the inhaler canister and both thumbs on the base of the inhaler.
Patients should rinse their mouth, gargle with water or brush the teeth after inhaling and spit out the residue to minimise the risk of oral candidiasis or dysphonia.
Cleaning: Patients should be advised to read the Patient Information Leaflet carefully for cleaning instructions: The inhaler should be cleaned once a week.
Remove the mouthpiece cover.
Do not remove the canister from the plastic casing.
Wipe the inside and outside of the mouthpiece and the plastic casing with a dry cloth or tissue.
Replace the mouthpiece cover in the correct orientation.
Do not put the metal canister into water.
If a patient requires an AeroChamber Plus/Flow-Vu spacer device then they must be advised to read the instructions provided by the manufacturer to ensure they use it and clean and maintain it properly.
Special precautions for disposal and other handling: No special requirements for disposal.
Incompatibilities: Not applicable.