Inhaling asthma medicines lets them go straight to the lung. As opposed to pills, they work faster and have fewer side effects. Asthma inhalers are basically divided into those that treat your symptoms, and those that prevent your symptoms. Treatment (rescue) inhalers include ProAir HFA, Xopenex HFA, Proventil HFA, and Ventolin HFA. Prevention (maintenance) inhalers include Advair, Symbicort, Dulera, Asmanex, Pulmicort, Flovent, Alvesco and some others.
Until 2009, generic albuterol was a popular rescue medicine. It was taken off the market because the propellant contained chlorofluorocarbons (CFCs). CFC inhalers have been replaced with hydrofluoroalkane (HFA) inhalers. The HFA propellant does not damage the ozone layer like CFC's do. Further, the HFA is a better propellant for asthma. The medicine comes out at 40 mph instead of 70 mph. It’s easier to make that sharp right turn to go into the lungs at 40 than 70. Additionally, HFA places albuterol into solution, rather than suspension like CFC's. Think of how tiny the salt particles are when dissolved in water (solution), and compare that to mixing sand with water (suspension). The sand particles are small, but they eventually settle out at the bottom.
Better dissolved, the albuterol HFA can penetrate into deeper, thinner parts of the lung, allowing for better dilatation of the breathing tubes. Old albuterol cost about $20.00 for 200 puffs, whereas HFA albuterol can cost $50.00 for 200 puffs. However, they sometimes have co-pay discounts at their websites. Right now, WalMart has the best bargain with a smaller size of Ventolin HFA called Ventolin ReliOn. It only has 60 puffs per inhaler, but only costs $9.00. Another downside of HFA’s is you have to rinse out your HFA device with running water every few weeks or it may clog up.
Some patients really prefer the old CFC inhalers. For them, we recommend asking their doctors to consider changing them to Maxair Autohaler. Unlike albuterol, this asthma rescue medication was not affected by the December, 2008 deadline. According to the March 29, 2007 issue of New England Journal of Medicine, it is "subject to withdrawal in the future". Per Maxair’s website, it will remain available in the USA through December, 2013.
Xopenex HFA is a newer form of albuterol, called levalbuterol. For many patients, it has fewer side effects than albuterol.
No matter which asthma rescue drug you use, if you're using it more than once a week, ask your doctor if you would benefit from an asthma controller inhaler. These inhalers prevent the swelling and inflammation that causes asthma in the first place.
Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.