Pressurized Metered Dose Inhaler Priming Instructions*

Lawrence D. Jackson,BScPhm, Clinical Coordinator, Veterans Centre, Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto

The process of testing the mouthpiece and canister of pressurized metered dose inhalers before use is called priming. Priming is recommended before using the inhaler for the first time (initial priming) or if you have not used the inhaler for a period of time (re-priming). Shake the inhaler and direct the recommended number of test sprays into the air, away from your face.

Drug / HFA-containing inhaler / Dose/puff;
# puffs/device / Initial Priming
(Release puffs into the air) / Re-priming
(Release puffs into the air)
Salbutamol
No dose counter / Apo-Salvent CFC Free® / 100 mcg;
200 / 4 puffs / 4 puffs if not used for 2 weeks
Novo-Salbutamol HFA® / 100 mcg;
200 / 4 puffs / 4 puffs if not used for 4 weeks
Salbutamol HFA(Sanis) / 100 mcg;
200 / 4 puffs / 4 puffs if not used for more than 5 days
Ventolin HFA / 100 mcg;
200 / 4 puffs / 4 puffs if not used for 4 weeks;
1 puff after cleaning
Salbutamol (in ethanol)
No dose counter / Airomir® / 100 mcg;
100 and 200 / 4 sprays / 4 sprays if not used for 14 days or more
Ipratropium bromide
No dose counter / Atrovent HFA® / 20 mcg;
200 / 2 puffs / 1 puff if not used for more than 3 days
Ipratropium bromide/ salbutamol SMI
Pointer indicates approximate amount remaining / CombiventRespimat / 20/100 mcg;
60 and 120 / Until cloud appears + 3 more times / 1 spray if not used for more than 3 days.
Full priming if not use for more than 21 days.
Tiotropium bromide SMI
Pointer indicates approximate amount remaining / Spiriva Respimat / 2.5 mcg;
28 and 60 / Until cloud appears + 3 more times / 1 spray if not used for more than 7 days.
Full priming if not use for more than 21 days.
Tiotropium bromide/olodaterol SMI
Pointer indicates approximate amount remaining / InspioltoRespimat / 2.5/2/5 mcg;
28 and 60 / Until cloud appears + 3 more times / 1 spray if not used for more than 7 days.
Full priming if not use for more than 21 days.
Beclomethasone (in ethanol)
No dose counter / QVAR® / 50 or 100 mcg;
100 and 200 / 4 sprays / 4 sprays if not used for 14 days or more
Fluticasone
No dose counter / Flovent HFA® / 50, 125 or 250 mcg; 60 and 120 / 1 puff / 1 puff if not used for 7 days or more
Ciclesonide (in ethanol)
No dose counter / Alvesco® / 100 or 200 mcg; 30 and 120 / 3 puffs / 3 puffs if not used for 7 days or more
Fluticasone/salmeterol
Dose counter shows # puffs remaining / Advair®
with dose counter / 125/25 or 250/25 mcg; 120 / 1 puff, repeat until dose counter reads 120 / 2 puffs if not used for 7 days or more
Mometasone/formoterol (in ethanol)
Dose counter shows # puffs remaining / Zenhale® / 50/5, 100/5 or 200/5 mcg; 120 / 4 puffs, dose counter should read 120 / 4 puffs if not used for 5 days or more

SMI- Soft Mist Inhaler, HFA- hydrofluoroalkane propellant,

*Sources: For generic drugs, information is taken from the package insert. For brand name drugs, the source is the product monograph in the Compendium of Pharmaceuticals and Specialties 2015

Contact: October 29, 2015