figure 1

Some asthma medications can be taken in the form of a dry powder using a small, hand-held device called a dry powder inhaler (DPI). Dry powder inhalers deliver medication to the lungs as you inhale through the device. The DPI does not contain propellants. It contains only the medication.

The Twisthaler (Figure 1) contains the inhaled corticosteroid mometasone (brand name is Asmanex©) which comes in 2 strengths 110 mcg (grey) and 220 mcg (pink). 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 out 45 days after this date or when the dose counter reads "00." (Figure 2 show the dose counter)

Preparing the Twisthaler

  1. While holding the Twisthaler upright, twist the white cap counter clockwise.
  2. figure 2

  3. As you twist and lift off the cap, the dose counter will decrease by one and the dose will be loaded. The medicine is now ready to be inhaled.

Inhaling the medication

  1. While holding the Twisthaler away from the mouth, gently blow out all the air from your lungs.
  2. Hold the Twisthaler horizontally and place the mouthpiece between your teeth sealing your lips tightly around the mouthpiece. (Figure 3)
  3. Breathe in rapidly and as deeply as you can.
  4. Hold your breath for 10 seconds.
  5. Replace the cap and twist clockwise. Make sure it clicks to completely close it. (This must be done to properly load the next dose)
  6. Repeat steps 3 through 7 for each dose ordered.
  7. Rinse your mouth and gargle (do not swallow) because this is a corticosteroid medication.

figure 4

figure 3

Caring for your Twisthaler DPI

  1. The Twisthaler has a dose counter (Figure 4) that automatically counts down the dose when the cap is removed. This action also loads the dose of medication. When the counter reads "00" there is no medicine left in the Twisthaler.
  2. Keep your dry powder inhaler in a dry place at room temperature.
  3. Never place the DPI in water.
  4. Never shake or breathe into the DPI.
  5. Never use a spacer device with your DPI.
  6. Unlike other inhaled medications, you may not taste or feel the dry powder or there may be a slight sweet taste. This experience may be different from what you are used to. As long as you are following the directions, you will get your full dose of medication.


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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/9/2016…#14757