• The medication comes in a metered-dose inhaler (called an "MDI"). It is usually taken four times a day, although sometimes more frequent dosing is necessary.
   
• You should "test-spray" each Combivent inhaler before your first use of it or if you have not used it for more than 24 hours. To test-spray the inhaler, simply spray it into the air three times by pressing on the top of the canister.
   
• Make sure to shake the inhaler vigorously for at least 10 seconds just before each spray.
   
• It is important to learn exactly how to use your inhaler. It may be difficult at first and require some practice.
   
• The spray should be inhaled into the lungs, not sprayed onto the back of the throat and swallowed. To accomplish this, you will need to breathe in while spraying the inhaler. Hold your breath for 10 seconds after each spray, and wait about two minutes between sprays (don't forget to vigorously shake the canister again).
   
• Most people put the mouthpiece of the inhaler directly into their mouths. However, many healthcare professionals now recommend placing the inhaler an inch or two away from the mouth. Talk to your healthcare provider about the best way for you to use the inhaler. If you have difficulty using it, your healthcare provider may recommend a spacer, a device that makes it easier to use the inhaler.
   
• Each inhaler contains 200 sprays. Try to keep track of how many sprays you have used, as it can be difficult to tell if the canister is empty. The canister may keep spraying after 200 sprays, but you cannot be sure that you are getting a full dose of Combivent after 200 sprays have been used.
   
• For Combivent to work properly, it must be taken as prescribed. The medication will not work if you stop taking it.