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Switching From a CFC to an HFA Asthma Inhaler - What Should I Expect?

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Updated: August 5, 2008

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Question: Switching From a CFC to an HFA Asthma Inhaler - What Should I Expect?

Over the past year or so, people with asthma have gradually been forced to switch from a type of metered dose inhaler that uses CFC propellants to push the medicine out of the inhaler canister to a newer, more environmentally-friendly HFA-powered metered dose inhaler. Naturally, this has aroused some anxiety. What is different? Will the new inhalers work as well? What should you expect exactly? And, will your asthma still be controlled as well?

Answer: Though CFC asthma inhalers have been used to treat asthma for years, they are now banned in the United States and many other parts of the world. CFC inhalers are safe for you to use, but they can deplete the earth's ozone layer -- our greatest protection from the sun's powerful rays. Because of this, the U.S. Food & Drug Administration (FDA) passed a law requiring drugmakers to repackage metered dose inhalers (MDIs) so they'll be healthier for our environment. This has been implemented via a gradual phase-out process that will be complete by the end of 2008.

So, let's try to answer some of the underlying questions about HFA inhalers.

What Is the Same?

  • The medicines in the HFA inhalers are the same as those in the CFCs.
  • The new inhalers have proven in rigorous FDA studies to be just as effective as the old ones.
  • The dose and frequency for individual medicines remains the same./

What Is Different?

  • The new inhalers may taste and smell slightly different.
  • Because the spray is less forceful, the HFA spray feels less cold coming out of the canister.
  • The HFA inhalers must be primed more than the old CFC inhalers needed to be.
  • They also need to be cleaned more often to avoid clogging.
  • There's more variation among brands of HFA inhalers than there was with the CFC versions. So, finding the one that works best might require a bit of trial and error.
  • They cost a lot more because there are not generic equivalents to the costly brands yet.

Tip: Read about how to overcome the challenges above to get the best out of your HFA inhaler Many drug companies are providing assistance with HFA inhalers for people who need it, offering discount coupons and free trials. You may also be able to get help at TogetherRxAccess.com.

Both controller medicines (such as Qvar) and quick-relief medicines (such as Albuterol) are now available in the HFA type of asthma inhaler. Since HFA asthma inhalers are the wave of the future, we may as well get used to them as quickly as possible.

Sources:

"FDA Proposing Phase Out of CFCs in Metered-Dose Inhalers for Epinephrine." U.S. Food and Drug Administration; 23 January 08. http://www.fda.gov/bbs/topics/NEWS/2007/NEW01706.html

"Topic of the Month - May - Transition to HFA Inhalers." American Academy of Allergy Asthma and Immunology; 23 January 2008. http://www.aaaai.org/patients/topicofthemonth/0507/

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