Seretide Caution For Usage

Incompatibilities: None reported.
Instructions for Use and Handling: Accuhaler: Accuhaler may be provided in a sealed foil overwrap which provides moisture protection. If so, the foil overwrap should only be opened when accuhaler is ready to use for the 1st 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.
Using the Seretide Accuhaler: Closed: When the Accuhaler is taken out of its box and the foil overwrap had been removed, it will be in the closed position.
Opened: A new Accuhaler contains 28 or 60 doses, individually protected doses of Seretide in powder form. The dose indicator indicates 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. Number 5 to 0 will appear in "red", to warn when there are only few doses left.
The Accuhaler is easy to use. When a dose is needed, follow the simple steps: Open, slide, inhale, close and rinse.
How the Accuhaler Works: Sliding the lever of the Accuhaler opens a small hole in the mouthpiece and unwraps a dose, ready for inhalation. When closing the accuhaler, the lever automatically moves back to its original position, ready for the next dose when needed. The outer case protects the Accuhaler when it is not in use.
How to Use the Accuhaler: 1. Open: 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 as far as it will go.
2. Slide: Hold the Accuhaler with the mouthpiece towards the patient. Slide the lever away, as far as it will go, until it clicks. The accuhaler is now ready to use. Everytime the lever is pushed back, a dose is made available for inhalation. This is shown by the dose counter. Do not play with the lever as this releases doses which will be wasted.
3. Inhale: Before starting to inhale the dose, follow the instruction carefully: Hold the Accuhaler away from the mouth. Breathe out as far as is comfortable. Never breathe into the Accuhaler. Put the mouthpiece towards the lips. Breathe in steadily and deeply through the Accuhaler, not through the nose. Remove the Accuhaler from the mouth. Hold breath for about 10 sec or as long as is comfortable. Breathe out slowly.
4. Close: To close the Accuhaler, put the thumb in the thumbgrip and slide the thumbgrip back towards the patient, as far as it will go.
When closing the Accuhaler, it clicks shut. The lever automatically returns to its original position and is reset. The Accuhaler is ready to use again.
5. Rinse: Afterwards, rinse mouth with water and spit it out.
If the patient has been instructed to take 2 inhalations, the patient must close the Accuhaler and repeat stages 1-4.
Note: Keep the Accuhaler dry. Keep it closed when not in use. Never breathe into the Accuhaler. Slide the lever only when ready to take a dose. Do not take exceeding the stated dose.
Evohaler: Testing the inhaler: Before using for the first time, remove the mouthpiece cover by gently squeezing the sides of the cover, shake the inhaler well, hold the inhaler between fingers and thumb with the thumb at the base, below the mouthpiece and release puffs into the air until the counter reads 120 to make sure that it works. The inhaler should be shaken immediately before releasing each puff. If the inhaler has not been used for a week or more remove the mouthpiece cover, shake the inhaler well and release two puffs into the air. Each time the inhaler is activated the number on the counter will count down by one.
In certain circumstances dropping the inhaler may cause the counter to count on.
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 firmly down on the top of the inhaler to release salmeterol and fluticasone propionate, while still breathing in steadily and deeply.
7. While holding breath, take the inhaler from the mouth and take the finger from the top of the inhaler. Continue holding breath for as long as is comfortable.
8. To take a second inhalation keep the inhaler upright and wait about half a minute before repeating steps 3 to 7.
9. Afterwards, rinse mouth with water and spit it out.
10. Immediately replace the mouthpiece cover in the correct position. The cap when correctly fitted will click into position. If it does not click into place, turn the cap the other way round and try again. Do not use excessive force.
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. Practise in front of a mirror for the first few times. If patient sees "mist" coming from the top of the inhaler or the sides of the mouth the patient should start again from stage 2.
Consider getting a replacement when the counter shows the number 020. When the counter reads 000 it must be replaced. Any puffs left in the device may not be enough to give a full dose.
Never try to alter the numbers on the counter or detach the counter from the metal canister. The counter cannot be reset and is permanently attached to the canister.
If the doctor has given different instructions for using the inhaler, please follow them carefully. Tell the doctor if patient has any difficulties.
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 two forefingers on top of the inhaler and both thumbs on the base below the mouthpiece.
Cleaning: The 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 or tissue.
4. Replace the mouthpiece cover in the correct position. The cap when correctly fitted will click into position. If it does not click into place, turn the cap the other way round and try again. Do not use excessive force.
Do not put the metal canister into water.