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1. Remove the cap and shake the Metered-Dose Inhaler.

2. Remove the cap on the SPACER DEVICE and insert the mouthpiece of the MDI into the opening at end of the SPACER DEVICE.

3. Place the SPACER DEVICE mouthpiece in mouth, making certain there are no air leaks. Check that the small holes on each side of the mouthpiece are not covered with the lips. Breathe normally into the SPACER DEVICE. Exhale.

4. Push down on the MDI canister to allow the medication to enter the SPACER DEVICE. Inhale slowly and deeply for about 3 - 5 seconds. After the inhalation, hold your breath for as long as possible, up to a count of ten.

NOTE: If you have trouble breathing deeply and holding your breath, inhale and exhale normally into the SPACER DEVICE 3 or 4 times.

5. Repeat steps 1 - 4 for the prescribed number of doses, waiting 60 seconds between inhalations.

6. Replace the cap on the SPACER DEVICE and on the MDI.

1. REMOVE the caps.
2. SHAKE the MDI.
3. ASSEMBLE MDI mouthpiece in the chamber.
4. SEAL LIPS around the SPACER DEVICE mouthpiece. EXHALE.
5. DEPRESS MDI into SPACER DEVICE. 6. INHALE slowly and deeply. Certain populations i.e. pediatrics and geriatrics may not be able to use a single breath technique. 7. BREATH HOLD for 5 - 10 seconds. 8. EXHALE.