Manufacturer's recommendations

The information leaflet [1] can be found on the brand's official website [2]. It provides the following recommendations: "Children younger than 18 months should inhale four to six times; children older than 18 months should inhale deeply two to four times. For adults, one breath is enough to inhale the medication from the spacer device." It also mentions that one should briefly hold their breath but does not specify the duration of apnea.

A review [3] published in the European Respiratory Society Open Research journal states that in order to enhance drug deposition in the respiratory tract, apnea should last between 4 to 10 seconds. If one inhalation is not enough, the tidal volume inhalation technique can be used, with the Global Initiative for Asthma (GINA) stating in its 2022 report [4] that "Generally, 5–10 breaths will be sufficient per actuation". Key points to consider are proper timing, not delaying breathing too much after pressing the inhaler; taking the deepest breaths possible, as shallow breaths significantly reduce the effectiveness of the inhalation; and effective sealing to prevent medication losses [5].