I was hesitant to use it for a very long time....foaming, hard to use. I don't mind it at all. It made me SOB until I did the right inhaler before.....xoponex 1.25.....and I lowered the dose to 75 instead of 150 per session.
Tips.....put sterile water into the vial a bit slowly, do not shake the bottle just roll it, let the bottle sit while you are doing albuterol before, draw it out, and put it in neb by injecting it slowly and letting run down the inside of neb instead of just pushing it straight into the neb...that helps with foaming.
PM if you have any other questions.