Patients Must Switch to CFC-Free Albuterol Inhalers
Patients with asthma and other lung diseases will have to switch inhalers on Jan. 1, 2009.
“I would say that most patients don’t know about the switch as of today,” said Neil Feldman, DO, of Allergy and Asthma Associates in Allentown.
The federal government has mandated that albuterol inhalers containing chlorofluorocarbons (CFCs) cannot be sold after Jan. 1, 2009, to comply with a 1987 treaty to protect the earth’s ozone. It’s the first time that the FDA has made a medication mandate for environmental reasons.
“By the 1990s, the majority of countries had made the switch. We’re behind the curve for changing over,” Dr. Feldman said.
Although CFC-free brand-name inhalers, which use the propellant hydrofluoroalkane (HFA), have been available for more than a decade, Dr. Feldman said he thinks most patients are using generic inhalers that contain CFCs.
“In January when the change occurs, all inhalers will be non-generic. That will actually increase the cost two or three times for some inhalers,” Dr. Feldman said.
Many insurers cover only one of the four brands available—Ventolin by GlaxoSmithKline, ProAir by Ivax, Proventil by Schering-Plough, and Xopenex by Sepracor.
Studies show that HFA inhalers are as effective as CFC inhalers and have the same side effects, but they differ in feel, force, and taste and how they are primed and cleaned.
According to the Food and Drug Administration (FDA), there are three critical differences between CFC and HFA inhalers. HFA inhalers:
- Must be primed by pumping four times
- Have a weaker spray—a warm, soft mist with a distinct taste
- Require a slower inhale
- Need to be washed with warm water and air dried once a week
The FDA has prepared a patient brochure on the transition.
Last Updated: 8/14/2008