All asthma inhalers designed up until the year 1996 used gases called chlorofluorocarbons (CFC) to propel the medications out of the can and hopefully into the asthmatic patient's lungs. Unfortunately, the propellant CFC depletes our earth's ozone layer and this is bad. Countries around the world recognized this fact and signed the Montreal Protocol on Substances that Deplete the Ozone Layer. This international treaty calls for the cessation of any manufacture and sale of any product that contains CFC by December 31, 2009. This means that soon generic albuterol inhalers and Azmacort inhalers will soon no longer be available. The FDA issued a public health advisory to alert the public specifically about albuterol inhalers on 5/30/08.
Two types of inhalers are now available. The first uses hydrofluoroalkane ( HFA ) as the propellant in inhalers. HFA does not deplete the ozone in the upper atmosphere. Patients may note the press-and-breathe inhalers now available all have the letter HFA in their name. The medication in rescue inhalers is still albuterol in three HFA inhalers. The brand names are Proair HFA, Proventil HFA, and Ventolin HFA. The medication in another inhaler called Xopenex HFA is levalbuterol, which is the stereoisomer of albuterol. The controller medications with HFA propellants are Advair, Flovent, Qvar, and Symbicort.
The second type of inhalers contains the medication in a dry powder form. This type of "dry powder" inhaler ( dpi ) does not contain any propellant. The medication is delivered into the lungs purely by the inspiratory force of the patients' lungs. There is only one dry powder inhaler with a rescue medication available. It is called Maxair Autohaler (AH). There a several dpi's available containing controller medications, such as Advair, Asmanex, Flovent, Foradil, Pulmicort, Serevent, and Spiriva.
There will be some minor effects and one major effect on patients. Note the medications are the same as those in the CFC inhalers, but they are being delivered into the lung differently. Patients may notice a different taste or smell due to the different propellants. Patients will have to get used to using a different device. Patients will note increasing difficulty getting albuterol CFC inhalers. While I agree that all CFC inhalers should be banned, as agreed in the Montreal Protocol, I also empathize with patients due to the higher cost of the HFA inhalers. This is the major effect on patients. This is aggravating. One helpful tip is to remember to check for coupons online. We are doing the right thing for our future and our children's futures by banning CFC products.
If you have questions about your rescue inhaler and the difference CFC or HFA, ask your doctor. The manufacturers of inhalers have formed a group and provide more information at http://www.ipacmdi.com/.