How to Use a Dry Powder Inhaler (DPI) — Turbuhaler, Ellipta, Handihaler | KiwiMeds

Dry powder inhalers (DPIs) deliver medication as a fine dry powder that you inhale. Unlike pMDIs, they do not use a propellant aerosol — instead, your own breath draws the powder into your lungs. This means your breathing technique is especially important. Each DPI device works slightly differently — follow the specific steps for your device below.

1. Turbuhaler (e.g. Pulmicort/Budesonide, Symbicort — if available)

1. 1
   Hold the Turbuhaler upright. Twist the red/orange grip to the right as far as it will go, then twist it back to the left until you hear a click. The device is now loaded.
2. 2
   Do not shake the Turbuhaler. Keep it upright after loading.
3. 3
   Breathe out gently — exhale away from the mouthpiece (not into it).
4. 4
   Place the mouthpiece between your teeth and seal your lips around it.
5. 5
   Breathe in as fast and as deeply as possible — the powder needs a strong, fast breath to reach the lungs. You may not feel or taste anything — this is normal.
6. 6
   Hold your breath for 5–10 seconds, then breathe out slowly.
7. 7
   If using a steroid preventer, rinse mouth and gargle with water — do not swallow. Replace the cap. Check the red dose indicator window — when it turns red, you have approximately 20 doses remaining.

2. Ellipta Devices (Breo Ellipta, Anoro Ellipta, Trillegry Ellipta)

1. 1
   Hold the inhaler flat with the mouthpiece facing you. Slide the cover down until you hear a click. The counter will decrease by one — the dose is now ready.
2. 2
   Do not shake the inhaler. Do not close the cover again — this will waste a dose.
3. 3
   Breathe out gently — away from the inhaler.
4. 4
   Put the mouthpiece in your mouth. Seal your lips around it.
5. 5
   Breathe in steadily and as deeply as possible. You may not taste or feel the powder — this is normal.
6. 6
   Hold your breath for 3–4 seconds (or as long as comfortable), then breathe out slowly.
7. 7
   Slide the cover back up over the mouthpiece. If using Breo Ellipta (steroid), rinse your mouth and gargle with water.

3. Handihaler (Tiotropium/Spiriva)

1. 1
   Open the dust cap by pressing the green button. Open the mouthpiece by pressing the green button and pulling it open.
2. 2
   Place one Spiriva capsule in the centre chamber. Close the mouthpiece until it clicks.
3. 3
   Hold the HandiHaler upright. Press the green button once to pierce the capsule. Release.
4. 4
   Breathe out away from the mouthpiece. Seal lips around mouthpiece, breathe in slowly and deeply until your lungs are full.
5. 5
   Hold breath for 10 seconds. You should hear the capsule rattling — this confirms the device is working. Remove from mouth and breathe out slowly.
6. 6
   Repeat steps 4–5 once more (inhale twice from each capsule). Open mouthpiece and remove the empty capsule. Close device.

Important Tips for All DPIs

• Keep DPIs dry — moisture damages the powder. Never breathe out into the device.
• Fast, deep breath — unlike pMDIs, DPIs need a fast, forceful inhalation to work properly.
• No spacer needed — DPIs should never be used with a spacer device.
• Store at room temperature — avoid bathroom cabinets due to humidity.
• Check the dose counter — do not rely on shaking to judge how full the device is.