Using Asmanex Twisthlaler

Patient instructions:

Check your asthma action plan to see when to take your Asmanex® Twisthaler®. Check the dose counter; it shows how many doses are left in the inhaler. Call for a refill when the dose counter reaches 20. If you use your inhaler after the dose counter reaches zero, you may not receive the correct amount of medicine.

Do not use a spacer(chamber) with your Twisthaler. Follow the steps below to take the medicine.

1. Open inhaler

   • Hold the inhaler up like a rocket with the colored base on the bottom.

   • Hold the colored base and twist the cap to the left to remove it.

   • Make sure the white arrow is on top of the dose counter.

2. Breathe out (exhale)

   • Blow all the air out of your lungs. Do not blow into the Twisthaler.

3. Inhaling from Twisthaler. Images use with permission from Merck & Co., Inc.

   Breathe medicine in (inhale)

   • Place the mouthpiece of the Twisthaler in your mouth and close your lips.

   • Take a quick big breath in. Do not cover the ventilation holes when you breathe in.

4. Hold your breath

   • Take the Twisthaler out of your mouth and hold breath for 10 seconds.

   • The medicine is a fine powder. You may not be able to taste, smell or feel the medicine. Do not take an extra dose from the inhaler even if you do not taste or feel the medicine.

5. Replace inhaler cap

   • Make sure the arrow is lined up with dose counter.

   • Put the cap back on the inhaler and turn to the right while pressing down until you hear a click.

6. Repeat the steps above if you are prescribed more than 1 puff of medicine.

7. After taking your prescribed number of inhalations, rinse your mouth with water without swallowing. This helps reduce the risk of a fungal infection (thrush) in your mouth.

Instructions for care and storage:

• Keep your inhaler clean and dry at all times. Do not wet or wash the inhaler.

• Store at room temperature 59°F to 86°F.  Keep away from heat and humidity

Reviewed November 2024 by Nilesh Seshadri, MD