What is a dry powder inhaler (DPI)?

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). DPIs deliver medication to the lungs as you inhale through the device. The DPI does not push the medication into your lungs. You will have to breathe in strong and steady to get the medicine.

What is the Flexhaler® DPI?

The Flexhaler® contains either 60 or 120 doses of medication (brand name is Pulmicort® and generic name is budesonide). It has a dose counter below the mouthpiece which is marked in intervals of “10” (which includes alternating numbers and dashes). The dose counter should be read at the middle of the window. The dose counter will _not _move with each individual dose, but you'll notice it move ahead about every five doses. When the number “0” has reached the middle of the window, no medicine is left in the Flexhaler. Throw away the empty Flexhaler and begin using a new one.

How do I prepare the Flexhaler?

When you get a new Flexhaler, you must prepare/prime it before you can use it.

  1. Hold the Flexhaler upright with the brown grip at the bottom.
  2. Twist and remove the white cover.
  3. Holding it in the middle, twist the brown grip on the bottom in one direction until it stops and then twist fully back again. You will hear a click. It doesn't matter which directions you twist first.
  4. Repeat a second time.
  5. Your new Flexhaler is now primed and ready to be loaded with a dose. (Remember, you only need to prime the Flexhaler the first time you use it.)

How do I load a dose and inhale my medication?

To load a dose, hold the Flexhaler with the mouthpiece facing up to ensure proper loading of the medication. Twist the brown grip fully in one direction as far as it will go and then twist fully back again. You'll hear a click. The Flexhaler is now loaded with a dose. Don't shake the Flexhaler after loading a new dose.

  1. While holding the Flexhaler level and away from your mouth, gently blow out all of the air from your lungs.
  2. Place the Flexhaler mouthpiece between your teeth, sealing your lips tightly around the mouthpiece.
  3. Breathe in strong and steady, but not too fast, and fill your lungs completely.
  4. Hold your breath for 10 seconds.
  5. Remove the Flexhaler from your mouth and exhale slowly. Wipe off the mouthpiece.
  6. If more than one dose is prescribed, repeat the previous steps for each dose.
  7. Rinse your mouth and gargle (do not swallow), then spit, because this is a steroid medication.

How do I care for my Flexhaler DPI?

  • Keep your Flexhaler in a dry place at room temperature.
  • Never place the Flexhaler in water.
  • Never shake or breathe into the Flexhaler.
  • Never use a spacer device/holding chamber with the Flexhaler.

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're used to. As long as you're following the directions, you'll get your full dose of medication.

Last reviewed by a Cleveland Clinic medical professional on 12/21/2020.


  • U.S. National Library of Medicine. PULMICORT FLEXHALER (budesonide) aerosol, powder (http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=cf2c0eb4-f95a-465c-b7e4-e0b3c06924bb) Accessed 3/4/2014.

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