Why Did My Albuterol Inhaler Change?

 Many people with asthma have noticed a change in their albuterol inhaler recently – the old, white generic CFC (chlorofluorocarbon)-propellant albuterol inhalers have been replaced by brand-name HFA-propellant albuterol inhalers. While this change is in the interest of the environment and preservation of the earth’s ozone layer, many asthmatics are less than thrilled about the change. First, since there are no generic HFA albuterol inhalers, the cost is dramatically higher than before. Second, many of my patients have told me that they feel that the new inhalers don’t work as well – often because the spray isn’t as forceful from the HFA inhalers – and therefore the medication doesn’t seem to get into the lungs as well.

While people may still be able to find some generic CFC-albuterol inhalers on pharmacy shelves, there will be none left within the next year. This change to HFA-based inhalers also affects inhaled steroids, none of which are currently generic. There are only three brands of HFA albuterol: ProAir, Proventil and Ventolin. Of these, ProAir is the least expensive, but also has the weakest spray, which some asthmatics find less satisfying, and maybe less effective. Ventolin seems to have the most powerful spray of the three, and also has a dose-counter to track medication usage and amount remaining.

While I doubt there is a difference in the effectiveness of the three HFA albuterol inhalers, some asthmatics certainly think so. Correct inhaler technique should always be used, and the use of a spacer may make the less forceful sprays more effective. Still, when an asthmatic can’t breathe, a stronger spray from an albuterol rescue inhaler may be more satisfying, even if there’s no real difference in the amount of medication delivered to the lungs.

Read more about living with asthma.

Source:

Leo HL, Dombkowski KJ, Clark NM. The Economic Effect of the Hydrofluoroalkane Albuterol Transition on Children with Asthma. J Allergy Clin Immunol. 2008; 121:776-7.

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