Transition to HFA Inhalers
Time is running out to switch inhalers
Many popular asthma inhalers won’t be available after the end of the year. If you haven’t already, start working with your child’s allergist/immunologist now to make the transition to the new versions of these inhalers.
The United States has committed, along with most of the world, to discontinue use of chlorofluorocarbons (CFCs) because of their damaging effects on the environment. As part of that effort, the U.S. Food and Drug Administration (FDA) is requiring that manufacturers of albuterol metered dose inhalers use hydrofluoroalkane (HFA) instead of CFCs to propel the medicine out of the inhaler. CFC inhalers will no longer be sold after December 31, and the pharmaceutical industry is already decreasing their production of CFC inhalers while increasing their production of HFA inhalers.
Patients will need a new prescription to receive these medications, so make an appointment with your child’s allergist/immunologist to discuss the transition.
For over 50 years, patients have relied on their metered dose inhalers to relieve asthma symptoms – such as chest tightness or difficulty breathing. Today’s HFA inhalers are as effective as CFC inhalers and use the same medication, albuterol.
Still, many pediatric patients notice differences between the inhalers and some parents have been concerned that the new HFA inhalers may not provide the appropriate dose of medication. However, HFA inhalers deliver the same dose of medication as CFC inhalers and provide the same relief of asthma symptoms.
Much of the confusion stems from changes to how the medication feels. The force of the HFA inhaler spray is softer than the CFC inhaler and may make it easier to get the medication into your child’s lungs. The new spray also has a warmer feel, rather than the cold blast of CFC inhalers. If your child complains of a different taste, have her follow the inhaler with a pleasant-tasting cold drink.
CFC vs. HFA Inhalers
Same medication dosage
Medication feels cold
Medication is delivered in a sharp burst
Generics and name-brand drugs available
Medication feels warm
Medication is delivered in a soft mist
Name-brand drugs only
There are currently four brands of albuterol HFA inhalers available. Your child’s allergist/immunologist can help select the most appropriate inhaler. As with all devices, regular maintenance and cleaning is necessary to keep HFA inhalers functioning properly. Inhalers should be cleaned at least once each week and must be “primed” before use. HFA inhalers should never be immersed in water. Read the instructions included with your child’s inhaler to learn about proper cleaning and priming of the device.
Cleaning Care for HFA Inhalers
- Look at the inhaler’s tiny exit port. If there is powder or other residue in or around the port, it is time to clean.
- Remove the canister from the L-shaped plastic mouthpiece.
- Rinse the mouthpiece and cap in warm water.
- Let the mouthpiece and cap dry overnight.
- Put the canister back inside the mouthpiece and place the cap back on the inhaler.
Note: Never place CFC or HFA metal canisters in water to judge if there is product remaining in canister; this water “float test” can damage the inhaler.
Currently, only brand-name HFA inhalers are available. Since there are no generic versions available, most patients will pay more for an HFA inhaler than a CFC inhaler. The HFA inhaler may cost anywhere from $30.00 to $60.00, depending on insurance coverage and co-pays. Patients in need of financial assistance should contact the Partnership for Prescription assistance by calling 1-888-477-2669.
For more information on the transition to HFA inhalers, including frequently asked questions, visit www.aaaai.org/patients.
Note: Inhalers should be used only as a back-up measure to treat asthma – as pre-treatment for exercise-induced asthma symptoms, before being exposed to allergens or for rapid relief of asthma symptoms. If your child uses her inhaler daily, contact an allergist immunologist to get her asthma under control. Find an allergist/immunologist in your area.
Sandra M. Gawchik, DO, FAAAAI, is an allergist/immunologist based in Upland, Pennsylvania.
Reprinted with the permission of the American Academy of Allergy Asthma & Immunology. © 1996-2008 American Academy of Allergy Asthma and Immunology. All Rights Reserved.
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