Shake the foam container vigorously for 5-10 seconds before each use. Do not remove the container cap during use of the product. (2) Hold the container upright on a level surface and gently place the tip of the applicator onto the nose of the container cap. CONTAINER MUST BE HELD UPRIGHT TO OBTAIN PROPER FLOW OF MEDICATION. (3) Pull the plunger past the fill line on the applicator barrel. (4) To fill the applicator barrel, press down firmly on the cap flanges, hold for 1–2 seconds and release. Pause 5–10 seconds to allow foam to expand in the applicator barrel. Repeat until foam reaches fill line. Remove applicator from the container cap. Allow some foam to remain on the applicator tip. A burst of air may come out of the container with the first pump. (5) Hold the applicator firmly by the barrel, making sure that the thumb and middle finger are positioned securely underneath and resting against the barrel wings. Place the index finger over the plunger. Gently insert applicator tip into anus. Once in place, push the plunger to expel foam, then withdraw applicator. CAUTION: Do not insert any part of the aerosol container directly into the anus. Apply foam to anus only with enclosed applicator. (6) After each use, the applicator parts should be pulled apart for thorough cleaning with warm water. The container cap and underlying tip should also be pulled apart and rinsed to help prevent build-up of foam and possible blockage