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HFA Asthma Inhalers: Making the Switch

Deadline to make the transition to HFA inhalers is fast approaching. WebMD explains how HFA inhalers differ from CFC inhalers and how to make the changeover easier.

4. How many quick-relief inhalers do people with asthma need in the course of a year? continued...

He says many people with asthma use the rescue inhalers far more than they should. People whose asthma is under control might need to use the inhaler once or twice a week, or if they exercise, a few times more.

"Many use more because, let's face it, a large percentage of asthmatics are not being optimally controlled," he says. "It's the patient, the doctor, the system, the cost - it's everything."

According to the Asthma and Allergy Foundation of America, a typical drug regimen for someone with asthma includes a rescue inhaler along with two controller medications, usually an inhaled steroid and a long-acting bronchodilator or a drug that combines both of the latter.

5. How many people are already using the HFA inhalers?

The FDA isn't tracking the number of people using the HFA inhalers, which have been on the market for a varying number of years, agency spokesman Christopher Kelly said during a May 30 news conference on the switch to HFA-propelled albuterol inhalers.

The FDA's director of the division of pulmonary and allergy products, Badrul Chowdhury, MD, did say during the same new conference that 65% of the 52 million albuterol prescriptions written annually are for HFA inhalers. Albuterol is one of the top 10 medications prescribed in the U.S.

That means that more than one third of albuterol inhalers prescribed are still in CFC form.

6. With only a few months to go before the CFC inhalers disappear from the market, how is the transition going?

Not as smoothly as it should. Although the EPA and FDA made the decision to make the change in 2005, there is an urgent need to get the word out about the switch to HFA inhalers, says Charlotte Collins, director of public policy and advocacy at the Asthma and Allergy Foundation of America in Washington, D.C.

"We're hearing from patients who are getting newer inhalers saying they don't work for them, but they haven't had training from their doctors, who may be prescribing them without telling patients. It takes a different patient training process to use them properly," she tells WebMD. "I'm very concerned we're going to have people as of Jan. 1 who aren't going to be able to refill prescriptions and they'll panic. That's not good for asthmatics."

Patients are also reporting they don't like the taste and smell of the HFA inhalers and don't know how to prime them.

"Until patients get an opportunity to try them several times and get some real training, it's hard to assess whether there are across-the-board issues. That's a major undertaking that hasn't been done yet, and it's a real shame. We really haven't road-tested this product among a 'real' patient community," Collins says.

Three years ago, the AAFA issued a statement called Transition Now (available at www.transitionnow.org) to alert patients to the change and explain the difference between the two inhalers. And earlier this year, the AAFA joined a working group that includes the Allergy and Asthma Network Mothers of Asthmatics and the American Lung Association to press the FDA to ramp up efforts to educate the public about the change.

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