Asthma Inhalers Are No Longer Using Ozone Destroying CFCs
The down side: The new inhalers cost more, $30 to $60 compared to as little as $5 or $10 for the disappearing generic CFC inhalers.
And patients face a learning curve. HFA inhalers must be used differently than the old-fashioned kind. The medicine feels and tastes different, sometimes alarming new users despite doctors assurances that it works just as well.
“Theres still significant confusion,” says Dr. Harvey Leo of the University of Michigans C.S. Mott Childrens Hospital. “Patients will tell you, I dont feel the puff anymore.”
Calls from parents unsure how to use the new inhalers, or even what they are, have increased in the past two months as more drugstores run out of CFC-powered inhalers and automatically switch people whod been expecting a mere refill, he adds.
The change shouldnt be a surprise. The Food and Drug Administration has long warned it was coming, and lung specialists have spent the past year easing many of the nations 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.
Some patients may purposefully be buying up cheaper CFC inhalers before the sales ban. But many patients dont see a lung specialist, or their prescription may not expire until next year so they havent been seen recently enough to be told.
Reaching the last fraction “is, as you can imagine, a very difficult task,” says Dr. Bidrul Chowdhury, FDAs pulmonary drugs chief. “How to get to somebody who is not tuned in?”
The CFC-free options: GlaxoSmithKlines Ventolin HFA, Schering Ploughs Proventil HFA and Teva Specialty Pharmaceuticals ProAir HFA all contain albuterol. Also, Sepracors 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 whos using the albuterol inhaler more than a few times a month isnt 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.
Heres the rub: Recent research suggests only one in five children has their asthma under good control; no one knows how many adults do.
Albuterol manufacturers are providing free samples and posting coupons on their Web sites.
Still, specialists worry that some patients will try to save money with a decades-old nonprescription inhaler that contains a different drug, epinephrine, best known by the brand name Primatene Mist – inhalers that also contain ozone-harming CFCs. National asthma guidelines argue against such self-treatment as too risky and less effective than albuterol. The government will allow sale of those over-the-counter inhalers until December 2011 as manufacturers reformulate.
Leo has another concern: Only one of the new inhalers counts doses used. Hes monitoring emergency-room statistics to see if cost-conscious patients trying to squeeze out last drops wind up using empty inhalers.
What do patients need to know as they switch?
-Expect a softer puff instead of the CFC versions cold blast of air in the back of the throat.
Source: sccha