Banned in Boston (And the Rest of the USA)

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Many patients with asthma have had trouble getting their generic albuterol inhalers filled lately. The propellant of the generic albuterol is chlorofluorocarbons, and all CFC-containing albuterol inhalers in the United States must be withdrawn by the end of 2008.

Replacing them are albuterol HFA products. The HFA propellant does not damage the ozone like CFCs do. Further, the albuterol dissolves better in a HFA, and penetrates deeper into the lungs, which allows for better dilatation of the breathing tubes.

Since no HFA albuterol is generic, they are more expensive to buy; however, the ProAir HFA brand has a $15 discount voucher you can print from its website. Temporarily, there is also a link there to get a whole prescription of ProAir HFA for free.

HFAs feel different from CFC inhalers. They're not as cold, and they come out much slower. That makes it easier to inhale them into the lungs instead of having most of it whack into the back of your throat. You do have to rinse out your HFA device every few weeks or it may clog up.

Instructions are available online at Proventil®HFA. Their site also has a $15 rebate you can print and temporarily has a free transition kit that includes a voucher for a whole prescription of Proventil HFA.

Some patients really prefer the old inhalers. For them, I recommend asking their doctors to prescribe Maxair Autohaler or the Alupent inhaler. Unlike albuterol, neither of those asthma rescue medications is affected by the 2008 deadline. According to the March 29, 2007 New England Journal of Medicine, they are “subject to withdrawal in the future”.

No matter which asthma rescue drug you use, if you're using it more than once or twice a week, ask your doctor if you would benefit from an asthma controller inhaler. These wonderful additions prevent the swelling and inflammation that causes asthma in the first place.

David B. Engler, MD

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.