When This Medicine Should Not Be Used:
This medicine is not to be used during an asthma attack.

How to Use This Medicine:
Aerosol

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• This medicine is a powder that is used in adults and children who are 6 years of age and older. It is breathed in with a special inhaler device that comes with the medicine. The powder is stored inside this inhaler. You will use this medicine with a device called a metered-dose inhaler. The inhaler fits on the medicine canister and turns the medicine into a fine spray that you breathe in through your mouth and to your lungs. You may be told to use a spacer, which is a tube that is placed between the inhaler and your mouth. Your caregiver will show you how to use your inhaler and the spacer (if needed).
• Open and position the inhaler by pulling the built-in purple actuator out from the gray spacer and snap into an "L" shape before using it.
• The first time you use the inhaler, or if you have not used the inhaler for 2 weeks or longer, prime the inhaler before use by shaking it well and then releasing a test spray away from your eyes and face. Press down on the metal canister two times for one second each in order to release 2 test sprays into the air.
• To inhale this medicine, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece just in front of your mouth with the canister upright.
• Open your mouth and breathe in slowly and deeply (like yawning), and at the same time firmly press down on the top of the canister once.
• Hold your breath for about 5 to 10 seconds, and then breathe out slowly.
• If your doctor has prescribed 2 or more sprays at each use, wait for 20 seconds, and follow exactly the same steps you used for the first puff.
• When you have finished all your inhalations, rinse your mouth out with water. You may also want to brush your teeth.
• Each inhaler comes with a Check-Off chart to track the number of puffs you have used. Mark off or check through each of your doses. Before you reach the last number of sprays, call your doctor to find out if you need a refill. You must discard the inhaler, actuator, and spacer after 60 sprays even if the canister is not empty. Do not place the canister under water to find out the amount of medicine still left in the canister.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are using medicine that weaken your immune system, such as steroid medicines (such as dexamethasone, hydrocortisone, methylprednisolone, prednisolone, prednisone, Medrol®).

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have bone problems (osteoporosis), cataracts, glaucoma, or any type of infection, especially a lung infection such as tuberculosis (TB), or a herpes infection of the eye.
• This medicine will not stop an asthma attack that has already started. Your doctor may prescribe another medicine for you to use in case of an acute asthma attack.
• If any of your asthma medicines do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor.
• You may get infections more easily while using this medicine. Tell your doctor right away if you have been exposed to someone with chickenpox or measles.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Your doctor may want you to carry a medical identification card stating that you are using this medicine and that you may need additional medicine during an emergency, a severe asthma attack or other illness, or unusual stress.
• This medicine may increase your risk of having an adrenal gland that is less active than normal. This is more likely for people who use steroids for a long time. Check with your doctor right away if you have more than one of the following symptoms: darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.
• This medicine may decrease bone mineral density when used for a long time. A low bone mineral density can cause weak bones or osteoporosis. If you have any questions about this, ask your doctor.
• This medicine may cause children to grow more slowly than normal. This would cause a child not to gain weight or get taller. Talk with your doctor if you think this is a problem.
• Check with your doctor right away if you have blurred vision, difficulty with reading, or any other change in vision while using this medicine. Your doctor may want your eyes to be checked by an eye doctor.
• This medicine may cause paradoxical bronchospasm, which may be life-threatening. Check with your doctor right away if you have a cough, difficulty with breathing, shortness of breath, or wheezing.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
• Call your doctor if your symptoms do not improve or if they get worse.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Changes in vision
• Fever, chills, cough, runny or stuffy nose, sore throat, and body aches
• Lightheadedness, dizziness, or fainting
• Sores or white patches in your mouth or throat
• Unusual tiredness or weakness
• Worsening of asthma symptoms

If you notice these less serious side effects, talk with your doctor:

• Dry mouth, hoarseness, or changes in voice
• Headache

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088