Step 1: Opening your HANDIHALER device
• Open the dust cap (lid) by pressing the green piercing button.
• Pull the dust cap (lid) upwards away from the base to expose the mouthpiece.
• Open the mouthpiece by pulling the mouthpiece ridge up and away from the base so the center chamber is showing.

Step 2: Inserting the SPIRIVA capsule into your HANDIHALER device
• Each day, separate only 1 of the blisters from the blister card by tearing along the perforated line.
• Remove the SPIRIVA capsule from the blister.
• Place the SPIRIVA capsule in the center chamber of your HANDIHALER device.
• Close the mouthpiece firmly against the gray base until you hear a click. Leave the dust cap (lid) open.

Step 3: Piercing the SPIRIVA capsule
• Hold your HANDIHALER device with the mouthpiece pointed up.
• Press the green piercing button once until it is flat (flush) against the base, then release. This is how you make holes in the SPIRIVA capsule so that you get your medicine when you breathe in.
• Do not press the green button more than one time.
• Do not shake your HANDIHALER device.
• The piercing of the SPIRIVA capsule may produce small gelatin pieces. Some of these small pieces may pass through the screen of your HANDIHALER device into your mouth or throat when you breathe in your medicine. This is normal. The small pieces of gelatin should not harm you.

Step 4: Taking your full daily dose
• Breathe out completely in 1 breath, emptying your lungs of any air.
• Hold your head in an upright position while you are looking straight ahead.
• Raise your HANDIHALER device to your mouth in a horizontal position. Do not block the air intake vents.

• Close your lips tightly around the mouthpiece.
• Breathe in deeply until your lungs are full. You should hear or feel the SPIRIVA capsule vibrate (rattle).
• Hold your breath for a few seconds and, at the same time, take your HANDIHALER device out of your mouth.
• Breathe normally again.
• To get your full daily dose, you must again, breathe out completely and for a second time, breathe in from the same SPIRIVA capsule. (Do not press the green piercing button again.)

Reference: 

SPIRIVA HANDIHALER Package Insert