Instructions for Use and Handling: Acuhaler: The Accuhaler may be provided in a sealed foil overwrap which provides moisture protection. If so, the foil overwrap should only be opened when the patient is ready to use the Accuhaler for the first time. Once removed/opened, the foil overwrap should be discarded.
The Accuhaler releases a powder which is inhaled into the lungs.
The device is opened and primed by sliding the lever. The mouthpiece is then placed in the mouth and the lips closed around it. The dose can then be inhaled and the device closed.
A dose indicator on the Accuhaler indicates the number of doses left.
Instructions for use of the SERETIDE Accuhaler: Closed: When Accuhaler is taken out of its box, remove any foil overwrap that may be present, the Accuhaler, will be in the closed position.
Opened: A new Accuhaler contains 28 or 60 doses individually protected doses of salmeterol/fluticasone propionate, in powder form. The dose indicator tells how many doses are left.
Each dose is accurately measured and hygienically protected. It requires no maintenance and no refilling.
The dose indicator on top of the Accuhaler tells how many doses are left. Numbers 5 to 0 will appear in Red, to warn the patient when there are only a few doses left.
The Accuhaler is easy to use. When the patient needs a dose,just follow the five simple steps must be followed: 1. Open. 2. Slide. 3. Inhale. 4. Close. 5. Rinse.
How the Accuhaler Works: Sliding the lever of Accuhaler opens a small hole in the mouthpiece and unwraps a dose, ready for the patient to inhale. When the Accuhaler is closed, the lever automatically moves back to its original position, ready for the next dose when the patient needs it. The outer case protects the Accuhaler when it is not in use.
1. Open: How to Use the Accuhaler: To open the Accuhaler, hold the outer case in one hand and put the thumb of the other hand on the thumbgrip. Push the thumb away from as far as it will go.
2. Slide: Hold the Accuhaler with the mouthpiece towards himself/herself. Slide the lever away from himself/herself, as far as it will go, until it clicks. The Accuhaler is now ready to use. Every time the lever is pushed back, a dose is made available for inhaling. This is shown by the dose counter. Do not play with the lever as this releases doses which will be wasted.
3. Inhale: Before the patient starts to inhale the dose, read through this section carefully.
Hold the Accuhaler away from his/her mouth. Breathe out as far as is comfortable. Remember, never breathe into the Accuhaler.
Put the mouthpiece to his/her lips. Breathe in steadily and deeply, through the Accuhaler, not through the nose.
Remove the Accuhaler from his/her mouth.
Hold breath for about 10 seconds, or for as long as is comfortable.
Breathe out slowly.
4. Close: To close the Accuhaler, the patient must put his/her thumb in the thumbgrip and slide the thumbgrip back towards himself/herself, as far as it will go.
When the patient close the Accuhaler, it clicks shut. The lever automatically returns to its original position and is reset. The Accuhaler is now ready for use again.
5. Rinse: Afterwards, rinse the mouth with water and spit it out.
If the patient have been instructed to take two inhalations, he/she must close the Accuhaler and repeat stages 1-4.
Remember: Keep the Accuhaler dry.
Keep it closed when not in use.
Never breathe into the Accuhaler.
Only slide the lever when the patient is ready to take a dose.
Do not exceed the stated dose.
Evohaler: Testing the Inhaler: Before using for the first time or if the inhaler has not been used for ≥1 week, remove the mouthpiece cover by gently squeezing the sides of the cover, shake the inhaler well and release 1 puff into the air to make sure that it works.
Using the inhaler: 1. Remove the mouthpiece cover by gently squeezing the sides of the cover.
2. Check inside and outside of the inhaler including the mouthpiece for the presence of loose objects.
3. Shake the inhaler well to ensure that any loose objects are removed and that the contents of the inhaler are evenly mixed.
4. Hold the inhaler upright between fingers and thumb with the thumb on the base, below the mouthpiece.
5. Breathe out as far as is comfortable and then place the mouthpiece in the mouth between the teeth and close the lips around it, but do not bite it.
6. Just after starting to breathe in through the mouth, press down on the top of the inhaler to release salmeterol and fluticasone propionate while still breathing in steadily and deeply.
7. While holding the breath, take the inhaler from the mouth and take the finger from the top of the inhaler. Continue holding the breath for as long as comfortable.
8. To take the 2nd puff, keep the inhaler upright and wait about ½ a min before repeating steps 3-7.
9. Afterwards, rinse the mouth with water and spit out.
The mouthpiece cover is replaced by firmly pushing and snapping the cap into position.
Important: Do not rush stages 5, 6 and 7. It is important to start to breathe in as slowly as possible just before operating the inhaler. Practice in front of the mirror for the first few times. If a "mist" is seen coming from the top of the inhaler or the sides of the mouth, start again from stage 2.
If the doctor has given different instructions for using the inhaler, follow them carefully. Tell the doctor when any difficulties are encountered.
Children: Young children may need help and an adult may need to operate the inhaler for them. Encourage the child to breathe out and operate the inhaler just after the child starts to breathe in. Practice the technique together. Older children or people with weak hands should hold the inhaler with both hands. Put the 2 forefingers on top of the inhaler and both thumbs on the base below the mouthpiece.
Cleaning: Your inhaler should be cleaned at least once a week.
1. Remove the mouth piece cover.
2. Do not remove the canister from the plastic casing.
3. Wipe the inside and outside of the mouthpiece and the plastic casing with a dry cloth, tissue or cottonbud.
4. Replace the mouthpiece cover.
Do not put the metal canister into water.
Incompatibilities: None reported.