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The Twisthaler puts a very fine dry powder into the lungs. You must take a deep and forceful breath in for the powder to reach your lungs.
When you get a new Twisthaler, remove it from the foil pouch and write the date on the cap. The Twisthaler will need to be thrown away 45 days after it is opened or when the dose counter reads "00."
Use a dry cloth to wipe the mouthpiece after use. Never get the Twisthaler wet.
The Twisthaler has a dose counter that counts down the dose by itself when the cap is removed. This also loads the dose of medicine. When the counter reads "00" there is no medicine left in the Twisthaler, throw it out and get a refill from the pharmacy.
Unlike other inhaled medicines, you may not taste or feel the dry powder. You may not know if the medicine is getting into your lungs. As long as you follow the directions, you will get the full dose of medicine.
Download instructions on how to use a Twisthaler (.pdf)