Symbicort Turbuhaler Caution For Usage

Incompatibilities: Not applicable.
INSTRUCTIONS FOR USE/HANDLING: Please read the complete instructions carefully before starting to take the medication.
Turbuhaler is a multidose inhaler from which very small amounts of powder are administered. When the patient breathes in through Turbuhaler the powder is delivered to the lungs. It is therefore important that the patient inhales forcefully and deeply through the mouthpiece.
How to prepare a new inhaler for 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 unscrewing the cover.
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 the patient turns first. During this procedure the patient will hear a click. Perform the procedure twice.
The inhaler is now ready for use, and the patient should not repeat this procedure again. To take a dose, please continue according to the instructions as follows.
How to use Symbicort Turbuhaler/Symbicort Forte Turbuhaler: To administer one dose, simply follow the instructions as follows.
1. Unscrew and lift off the cover. A rattling sound is heard when unscrewing the cover.
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 the patient turns first. During this procedure the patient will hear a click.
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 the mouth out with water. 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 he/she has inhaled the dose if the instructions were followed.
If the patient by mistake performs the loading procedure more than once before taking the dose, the patient will still only receive one dose. The dose indicator will, however, register all the loaded doses.
The sound heard if the patient shakes the inhaler is not produced by the medication but by a drying agent.
How to know when to replace the inhaler: The dose indicator tells the patient 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 he/she may not notice a movement in the dose indicator.
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.
Please 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 it. Ask the pharmacist for advice.