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Asthma Inhalers to go ‘Green’ on December 31

by The Kid's Doctor Staff

Asthma inhalers are set to go “green” on December 31, forcing patients who still use the old-fashioned kind to make a switch to a more expensive dispenser. The medicine inside the inhalers is not changing, but the chemicals used to puff the drug into the lungs is.

By year’s end, all albuterol inhalers must be powered by the more eco-friendly chemical HFA or hydrofluroalkane as opposed by being powered by chloroflurocarbos (CFCs). CFSc can damage the Earth’s protective ozone layer.

The change means that inhalers will cost more, $30 to $60 compared to as little as $5 to $10 for the disappearing generic CFC inhalers.

Patients also face a learning curve. HFA inhalers must be used differently than the old-fashioned kind. The medicine tastes and feels different, sometimes alarming new users despite doctor’s assurances that the medicine works just as well.

The Food and Drug Administration has long warned it was coming, and lung specialists have spent the past year easing many of the nation’s 20 million asthma patients – as well as millions of emphysema sufferers who also use albuterol to ease breathing – into it.

But industry figures show that in mid-November, 20 percent of all albuterol prescriptions still were being filled with CFC versions.

The CFC-free options: GlaxoSmithKline’s Ventolin HFA, Schering Plough’s Proventil HFA and Teva Specialty Pharmaceuticals’ ProAir HFA all contain albuterol. Also, Sepracor’s Xopenex HFA contains the similar medication levalbuterol.

Albuterol inhalers are for emergencies, for quick relief of wheezing. Patients also need daily medication to control their asthma and prevent flare-ups. Someone who’s using the albuterol inhaler more than a few times a month isn’t well-controlled, and his or her doctor needs to determine why, stresses Dr. Paul Greenberger of Northwestern University, president-elect of the American Academy of Allergy, Asthma & Immunology.

What do patients need to know as they switch?

  • Expect a softer puff instead of the CFC version’s cold blast of air in the back of the throat. “They are getting their medicine,” says Dr. David Rosenstreich of New York’s Montefiore Medical Center. “They have to get used to it and be aware that it’s working.”
  • The new inhalers clog more often because HFA makes the drug stickier. Clean the hole weekly, following the instructions unique to each brand.
  • Never get the whole device wet.

The FDA says there’s plenty of supply; it gave manufacturers several years to ramp up before the ban.

More Information: Food and Drug Administration

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