Symbicort Caution For Usage

Incompatibilities: Not applicable.
Turbuhaler 160/4.5 mcg/dose: Instruction for Use/Handling: Please read the complete instructions carefully before the patient start to take the medication.
Turbuhaler is a multidose inhaler from which very small amounts of powder are administered. When the patient breathes-in through the Turbuhaler, the powder is delivered to the lungs. It is therefore important to inhale forcefully and deeply through the mouthpiece.
How to prepare a new inhaler to use: Before using Turbuhaler for the first time, the patient needs to prepare the inhaler for use.
1. Unscrew and lift off the cover. A rattling sound is heard when the cover is unscrewed.
2. Hold the inhaler upright with the red grip downwards. Do not hold the mouthpiece when turning the grip. Turn the grip as far as it will go in one direction, and then back again as far as it will go; it does not matter which way it is turned first. During this procedure, a click will be heard. Perform this procedure twice.
The inhaler is now ready for use, and this procedure should not be repeated. To take a dose, continue according to the instructions as follows:
How to Use Symbicort Turbuhaler: To administer one dose, simply follow the instructions as follows:
1. Unscrew and lift off the cover. A rattling sound is heard when the cover is unscrewed.
2. Hold the inhaler upright with the red grip downwards. Do not hold the mouthpiece when turning the grip. To load the inhaler with a dose, turn the grip as far as it will go in one direction, and then back again as far as it will go; it does not matter which way it is turned first. During this procedure, a click will be heard.
3. Breathe-out. Do not breathe-out through the mouthpiece.
4. Place the mouthpiece gently between the teeth, close the lips and inhale forcefully and deeply through the mouth. Do not chew or bite on the mouthpiece.
5. Remove the inhaler from the mouth before breathing-out.
6. If more than one dose has been prescribed, repeat steps 2-5.
7. Replace the cover by screwing it back on tightly.
8. Rinse mouth with water after morning and evening dose. Do not swallow.
Note: Do not try to remove the mouthpiece since it is fixed to the inhaler. The mouthpiece can be rotated, but do not twist it unnecessarily.
As the amount of the powder dispensed is very small, the patient may not be able to taste it after inhalation. However, the patient can still be confident that the dose has been inhaled if the instructions have been followed.
If the patient by mistake performs the loading procedure more than once before taking the dose, only one dose will be received. The dose indicator will, however, register all the loaded doses. The sound heard when the inhaler is shaken is not produced by the medication but by a drying agent.
How to tell when to replace the inhaler: The dose indicator tells approximately how many doses are left in the inhaler starting with either 60 or 120 when full.
The indicator is marked in intervals of 10 doses. Therefore, it does not show the loading of each individual dose. The patient should be reassured that Turbuhaler delivers the dose even if a movement in the dose indicator is not noticed.
For the last 10 doses, the background of the indicator is red. When the zero reaches the middle of the window, it is time to discard the inhaler.
Note that even when the dose indicator registers zero, it is still possible to turn the grip. However, the indicator stops moving and the zero remains in the window.
Cleaning: Wipe the outside of the mouthpiece regularly (once a week) with a dry tissue. Do not use water or liquids when cleaning the mouthpiece.
Disposal: Always be sure to dispose the used Turbuhaler responsibly, in the recommended way, since some of the medicine will remain inside. Ask the pharmacist for advice.
Rapihaler: Instructions for use, handling and disposal: See Dosage & Administration. The canister should not be broken, punctured or burnt, even when apparently empty.
The canister contains a pressurised liquid. Do not expose to temperatures above 50°C.
Instructions for the correct use of Symbicort Rapihaler with a spacer device: The use of Symbicort Rapihaler with a spacer device is recommended to enable patients with difficulty in co-ordinating inhalation with actuation, such as young children or the elderly, to derive greater therapeutic benefit.
Note: It is important to instruct the patient to: Carefully read the instructions for use in the Patient Information Leaflet, which is packed with each inhaler.
Carefully read the instructions for use in the instruction leaflet which is packed with each spacer device.
On actuation of the aerosol, the dose is released into the inhalation chamber. The inhalation chamber is then emptied by two slow deep breaths. Young children may need to breathe 5-10 times through the mouthpiece. For further actuations, the procedure is repeated. For young children who are unable to breathe through the mouthpiece, a face mask can be used. Compatible face masks are available separately and care should be taken to ensure a good fit is achieved.