MDI Remove cap Shake well Breathe out normally Keep head upright or slightly tilted Seal lips around mouthpiece Inhale slowly, actuating once during first half of inhalation Continue slow and deep inhalation Hold breath for 5 or more seconds

MDI with spacer Remove caps Shake MDI well Insert MDI into spacer Breathe out normally Seal lips around mouthpiece Actuate MDI Inhale slowly and deeply Hold breath for 5 or more seconds

Diskus Open to expose mouthpiece Slide lever until click heard Keep level throughout Breathe out normally and away from inhaler Seal lips around mouthpiece Inhale forcefully and deeply Hold breath for 5 or more seconds Exhale but not through inhaler

Turbuhaler Hold upright without occluding air vents Turn coloured wheel one way, then back Breathe out normally and away from mouthpiece Seal lips around mouthpiece without occluding air vents Inhale forcefully and deeply Hold breath for at least 5 seconds Exhale but not through inhaler

HandiHaler Open lid and mouthpiece Place capsule in chamber Close mouthpiece, ensuring click is heard Holding inhaler upright, press blue button fully Breathe out normally and away from inhaler Seal lips around mouthpiece Inhale forcefully and deeply so that capsule vibrates Hold breath for 5 or more seconds Repeat steps 6–8

MDI = metered-dose inhaler.

^*Bold indicates steps that are critical, for which incorrect performance would lead to little or no medication reaching the lungs.