I can see it now. You’re sitting at your kitchen table, looking at the box from the pharmacy. Inside is a new inhaler that looks… a little intimidating. It’s a common feeling. When we prescribe a Dry Powder Inhaler, or DPI, for the first time, patients often worry they’ll do it wrong. But I promise, once you get the hang of it, it becomes second nature. Let’s walk through how to use your new Flexhaler® together, step-by-step. It’s much simpler than it appears.
What Exactly Is a Dry Powder Inhaler?
First, let’s clear up what this device does. Unlike the “puffer” inhalers (we call them metered-dose inhalers) that spray a mist of medicine into your lungs, a Dry Powder Inhaler is different. It holds the medicine as a very fine powder.
The key thing to remember is that the device doesn’t push the medicine out. Instead, you pull the medicine in with your own breath. This means you need to take a quick, deep breath to get the full dose into your airways where it can work on your asthma.
The Flexhaler® is one specific type of DPI. It contains a medication called budesonide (the brand name is Pulmicort®) which is a steroid that helps calm down inflammation in your lungs over time. It’s a controller medication, not a rescue inhaler.
You’ll notice a little dose counter window on it. It’s marked with numbers and dashes, usually in intervals of 10. A little quirk here: the counter doesn’t click down with every single dose. It moves every five or so puffs. When you see a “0” in the middle of that window, it’s time to throw the inhaler away and start a new one.
Using Your Flexhaler: A Step-by-Step Guide
Getting this right is all about following a simple process. I’ve broken it down into two parts: priming your inhaler the very first time you use it, and then the steps for your daily doses.
| Part 1: Priming Your New Inhaler (First Use Only) | |
|---|---|
| Step 1 | Hold the inhaler upright, with the brown grip at the bottom. Twist and pull off the white cover. |
| Step 2 | Hold the middle of the inhaler. Twist the brown grip all the way in one direction, then twist it all the way back. You should hear a “click.” The direction you twist first doesn’t matter. |
| Step 3 | Do Step 2 one more time. Twist and twist back until it clicks again. Your inhaler is now primed and ready. You only ever do this once for each new inhaler. |
| Part 2: Loading & Inhaling Your Daily Dose | |
| Step 1: Load | Hold the inhaler upright. Twist the brown grip all the way one way, and all the way back until it clicks. Your dose is now loaded. Do not shake it. |
| Step 2: Breathe Out | Turn your head away from the inhaler and breathe out fully. Get all the air out of your lungs. |
| Step 3: Inhale | Place the mouthpiece between your lips and close them tightly to create a seal. Breathe in deeply and quickly. |
| Step 4: Hold | Take the inhaler out of your mouth and hold your breath for about 10 seconds (or as long as is comfortable). |
| Step 5: Exhale & Rinse | Breathe out slowly. Now, this is important: because this is a steroid, you must rinse your mouth with water, gargle, and spit it out. This prevents side effects like a sore throat or oral thrush. Do not swallow the water. |
| Step 6: Repeat | If your doctor prescribed more than one puff, just repeat these steps for your next dose. |
A lot of my patients say, “Doc, I don’t feel or taste anything! Is it working?”
Yes! That’s completely normal with this type of inhaler. The powder is so fine you often won’t notice it. As long as you’re following the steps, you are getting your medicine.
Caring for Your Flexhaler
To make sure your inhaler works properly every time, there are just a few simple rules for taking care of it.
| Do This… | Avoid This… |
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We’ll always go over this in the clinic, but having a guide at home can make all the difference. Don’t hesitate to call if you feel unsure.
Take-Home Message
- The Flexhaler® is a Dry Powder Inhaler (DPI) that requires a quick, deep breath to deliver the medicine.
- You must prime a new inhaler before its first use, but only that one time.
- Always twist the base to load a dose, breathe out away from the device, then inhale deeply.
- It’s normal not to taste or feel the powder. Trust the process!
- Crucially: Always rinse your mouth, gargle, and spit after using this steroid inhaler to prevent oral thrush.
Taking control of your asthma is a huge step, and using your medication correctly is the most important part of that journey. You’re not alone in this, and you’ve got this.