Program Offers Info on Switching Albuterol Inhalers

For years, the FDA has been working to phase out albuterol metered-dose inhalers that use chlorofluorocarbons, or CFCs, as propellants, directing manufacturers instead to produce inhalers that use hydrofluoroalkane, or HFA, to deliver the drug. As the deadline for finalizing that change draws closer, family physicians can steer patients to a new American Lung Association program, CFC-Free Inhalers: Time to Make the Switch, that offers information about albuterol inhalers that use HFA and suggestions about prescription assistance programs.

According to information on the FDA Web site, most metered-dose inhalers, or MDIs, available in the United States originally were formulated using CFCs as propellants. To comply with a 1987 international treaty and subsequent U.S. statutes aimed at eliminating the use of ozone-depleting CFCs, many such inhalers have been or now are being reformulated to use the more ozone-friendly HFA. To ensure that patients who rely on these inhalers continue to have access to safe and effective treatment options, the FDA implemented a regulatory strategy to smooth the transition away from CFC-containing albuterol MDIs, setting Dec. 31, 2008, as the deadline to complete the switch.

Physicians should make clear to their patients that only MDIs that have albuterol as their sole active ingredient are affected by the FDA action. Brand-name examples of such products are Proventil and Ventolin. MDI brands that combine albuterol with another ingredient -- such as Combivent, which includes albuterol and ipratropium bromide -- are not covered by the current FDA action.

"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," says the ALA's CFC-Free Inhalers program Web page. "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."

The mist from HFA inhalers may be less forceful and warmer than the mist from CFC inhalers, advises the ALA. The site offers suggestions about cleaning HFA inhalers. In addition, the online materials include an educational brochure to download for patients and a form for requesting professional resources that are being developed.

HFA inhalers cost $30 to $60, compared with $5 to $25 for a generic CFC inhaler, says the ALA Web page. It encourages patients who have questions about HFA inhalers or who want to learn about prescription assistance programs to call the ALA at (800) LUNG-USA, or (800) 586-4872, and press "2" to speak with a nurse or respiratory therapist.

"It is very important to educate the asthma community about how to obtain, clean and operate HFA inhalers so people with asthma know what to expect during this transition period," said John Kirkwood, ALA president and CEO, in a Nov. 16 ALA news release.