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Many people who use inhalers containing the drug albuterol will need to change their inhalers. Manufacturers are phasing out one type of albuterol inhaler, called a CFC inhaler, and increasing production of another, called an HFA inhaler. If you use an albuterol inhaler, here’s what you need to know.
What Is Albuterol?
Albuterol is a type of drug known as a short-acting beta2-agonist. It quickly relaxes and opens airways and relieves asthma symptoms. This is a quick-relief medicine that only lasts about four hours. It does not prevent asthma attacks. Some people with chronic obstructive pulmonary disease (COPD) also use albuterol inhalers.
Why Are CFC Inhalers Being Phased Out?
The U.S. Food and Drug Administration (FDA) has told makers of albuterol inhalers that they must stop using the ozone-depleting propellants called chlorofluorocarbons (CFCs), which send albuterol into the lungs.
Manufacturers have already begun to make or ramp up production of CFC-free inhalers, also called hydrofluoroalkane (HFA) inhalers, in advance of the December 31, 2008 deadline.
This decision resulted from the United States’ participation in the Montreal Protocol, a 1987 international treaty to eliminate the production and consumption of ozone-depleting chemicals. The American Lung Association led the successful effort to have metered-dose inhalers (MDIs) exempted from the Montreal Protocol in 1994, to give inhaler manufacturers time to develop CFC-free devices and provide an adequate transition time for patients and doctors.
What Should I Do?
Some people have already switched over to the new HFA inhalers, either because they want to get comfortable with the new product or because their CFC inhaler is no longer available. Since everyone who uses an albuterol inhaler will have to stop using CFC inhalers by the end of 2008, now is a good time to speak with your physician about making the change. To get an HFA inhaler, you’ll need your doctor to write a new prescription—your pharmacist can’t simply substitute the new inhaler for your existing CFC inhaler prescription.
The FDA has found that HFA inhalers are safe and effective, and patients should not find any significant differences from their CFC inhalers. But it is possible that some patients might find that the new inhalers have a slightly different taste or feel. Since all HFA inhalers do not contain the same inactive ingredients, you may want to try out more than one kind in advance of the deadline to find the one you are most comfortable with.
Will I See a Price Difference?
There can be a significant price difference between the CFC inhalers and the new HFA inhalers, particularly if you currently use a generic CFC inhaler. The HFA inhalers cost from $30 to $60, compared with $5 to $25 for a generic CFC inhaler. The price difference is most likely to have an impact on patients without health insurance.
“Depending on your insurance, these new inhalers may be more expensive, but our hope is that as more people move to the CFC-free delivery method that the price will come down,” says Norman H. Edelman, M.D., Chief Medical Officer of the American Lung Association.
If you have questions about the transition to HFA inhalers or to learn about assistance programs that may help you pay for your prescriptions, including a coupon offer, call the American Lung Association Lung HelpLine at 1-800-LUNG-USA, and press “2” to speak to a nurse or respiratory therapist.
How Can I Reduce My Dependence on Albuterol Inhalers?
Since albuterol inhalers are not meant to control asthma in the long term, if you are using your inhaler more than two to three times a week, it means your asthma is not being properly controlled.
“If you are using your albuterol inhaler more frequently than this, talk to your doctor about taking inhaled steroids, which are recommended by the National Institutes of Health for controlling asthma,” says Dr. Edelman. Inhaled steroids reduce the airway swelling that makes asthma attacks more likely.
It is important to see your doctor regularly if you have asthma. Over time, you may need to increase or lower your dose of medicine, or change the type of medicine you take. Work with your doctor to find the best treatment to control your asthma.
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HFA versus CFC
Ozone-friendly HFA inhalers share many similarities with CFC inhalers, but there are some differences. Talk to your doctor, pharmacist or other healthcare professional about the HFA metered-dose inhaler.
| How They Are the Same |
How HFA Is Different |
| Safe and effective for the same FDA-approved uses |
Ozone-friendly to the environment |
| Shape is similar |
May be slightly different in smell and taste |
| Size is similar |
Mist is less forceful and warmer |
| Convenient to use |
May need to be cleaned and cared for differently |
Cleaning Your Inhaler
(These are generic instructions. Your physician or pharmacist may have specific instructions, depending on the brand of HFA inhaler you use.)
• Look at the inhaler’s tiny hole through which the medication sprays.
• If there is powder or other residue in or around the hole, it is time to clean your inhaler.
• Remove the canister from the L-shaped plastic mouthpiece.
• Rinse the mouthpiece and cap in warm water.
• Let the mouthpiece and cap dry all day or overnight.
• After the mouthpiece and cap have dried, put the canister back inside the mouthpiece and the cap back on the inhaler.
More Information
For the latest information on albuterol inhalers, visit the FDA website at www.fda.gov/cder/mdi/drugs.htm. You can also learn more about the transition to HFA inhalers or assistance programs at www.lungusa.org/cfcfree or by calling 1-800-LUNG-USA and pressing “2” to speak to a nurse or respiratory therapist. |
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