By Jan. 1, 2009, millions of Americans with asthma and those with chronic obstructive pulmonary disease will have to make the switch from CFC-propelled inhalers to HFA-propelled inhalers, if they haven't already.
The change comes as a result of a federal ban on CFC (chlorofluorocarbons) albuterol inhalers that goes into effect Dec. 31, 2008.
An asthma action plan is a written plan developed by your doctor or asthma specialist to help you or another family member, including teenagers and children, manage asthma and prevent asthma attacks. The plan is designed to tell you or other family members what to do when there are changes in the severity of asthma symptoms and in peak flow numbers.
For some asthma patients, like 35-year-old Shelby Rothrock of Silver Spring, Md., the new inhalers are a big improvement. She says she prefers the feel of the HFA (hydrofluoroalkane) inhalers. Albuterol is a short-acting bronchodilator, which helps open up airways to provide quick relief from wheezing and shortness of breath. Albuterol inhalers are often referred to as "rescue" inhalers because they can help stop asthma attacks. Albuterol is dispensed by both CFC and HFA inhalers in metered doses.
"Before, I felt like the medication worked but that most of it ended up in the back of my throat. It was a nice switch for me to have something that didn't blow out quite so hard," says Rothrock, whose job it is to run clinical trials for pharmaceutical companies.
Jim Brisko of Bloomfield Township, Mich., is similarly satisfied. He didn't even notice that his pharmacy gave him an HFA inhaler when he filled a prescription in February until his doctor pointed it out at his last visit in September.
The retired General Motors engineer says the HFA inhaler works just as well for him as the old CFC ones, but for others, the contrast between them is dramatic. They're pushing back with an online petition asking Congress to lift the ban on CFC inhalers, which was put in place in 2005 by the Environmental Protection Agency and the FDA to comply with the 1987 Montreal Protocol. That treaty was adopted globally to protect the earth's ozone layer, the thinning of which has been attributed in part to CFCs.
The National Campaign to Save CFC Inhalers is asserting that CFC-propelled inhalers are an insignificant source of pollution and that they are safer and more effective than HFA-propelled inhalers. As of late September, more than 2,800 people had signed the petition.
Patient advocates, however, say there is no turning back from the CFC inhaler ban. Their focus now is on educating health professionals and patients about using the HFA inhalers, and they've urged the FDA to do the same.
Confused about the switch? WebMD went to several experts to learn about the new inhalers, how they're different, and what's being done to make the transition between CFC and HFA inhalers easier. Read on for their answers.
1. What are the differences between CFC and HFA inhalers?
The primary difference is the way albuterol is propelled from the canister into the lungs, but some patients will notice that the "blast" of spray is gentler with HFA devices.