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U.S. Department of Health and Human Services

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Transition from CFC Propelled Albuterol Inhalers to HFA Propelled Albuterol Inhalers: Questions and Answers

Albuterol inhalers that contain chlorofluorocarbons (CFCs) will not be sold in the U.S. after December 31, 2008. Albuterol inhalers that contain hydrofluoroalkanes (HFAs) will take the place of albuterol CFC inhalers. Here are some questions and answers to help you understand the change.

Why are albuterol CFC inhalers being phased out?

The phase out of albuterol CFC inhalers is due to an international agreement called the Montreal Protocol on Substances that Deplete the Ozone Layer. CFCs are harmful to the environment because they decrease the protective ozone layer above the Earth.

When will albuterol CFC inhalers be gone?

Albuterol CFC inhalers will not be sold in the United States after December 31, 2008. The company that makes albuterol CFC inhalers is expected to stop making albuterol CFC inhalers before then. People who are using albuterol CFC inhalers should talk with their health care professional now about switching to an albuterol HFA inhaler. There are enough albuterol HFA inhalers for everyone who needs them.

What hydrofluoroalkane inhalers (HFA) (non-CFC albuterol inhalers) are available?

There are three albuterol HFA inhalers that FDA has approved as safe and effective:

  • ProAir (albuterol sulfate) HFA Inhalation Aerosol
  • Proventil HFA (albuterol sulfate) Inhalation Aerosol
  • Ventolin (albuterol sulfate) HFA Inhalation Aerosol

Also available is Xopenex HFA (levalbuterol tartrate) Inhalation Aerosol that contains the active form of albuterol and does the same thing as albuterol.

Patients in the United States have been using HFA inhalers safely and effectively since 1998.

How are albuterol HFA inhalers the same as albuterol CFC inhalers?  

Albuterol HFA inhalers are used in the same way as albuterol CFC inhalers and give the same dose of albuterol as the CFC inhalers. Albuterol HFA inhalers are safe and effective for the same FDA approved uses: treatment or prevention of bronchospasm in patients with reversible obstructive airway disease, including asthma and chronic obstructive pulmonary disease (COPD).

How are albuterol HFA inhalers different from albuterol CFC inhalers?  

CFCs are used as propellants (spray) to move the albuterol medicine out of the inhaler so patients can breathe the medicine into their lungs. HFAs are a different type of propellant (spray). The albuterol and levalbuterol HFA inhalers have a different propellant called hydrofluoroalkane (HFA). Albuterol HFA and albuterol CFC inhalers may taste and feel different. The force of the spray may feel softer from albuterol HFA than from albuterol CFC inhalers. Each of the HFA inhalers is different (see table below). Albuterol HFA inhalers have to be cleaned and primed to work in the right way and give the right dose of medicine. Each HFA inhaler has different instructions for cleaning and priming. The patient information that comes with each inhaler tells you how to clean and prime your inhaler.


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ProAir HFA
Albuterol and Levalbuterol HFA Inhalers
  Proventil HFA Ventolin HFA Xopenex HFA
Active ingredient Albuterol sulfate Albuterol sulfate Albuterol sulfate Levalbuterol tartrate
Inactive ingredients HFA propellant
alcohol
HFA propellant
alcohol
oleic acid
HFA propellant HFA propellant
alcohol
oleic acid
Dose Counter No No Yes No
Priming required Yes Yes Yes Yes
Cleaning required Yes Yes Yes Yes

Why is cleaning and priming my albuterol HFA inhaler important?  

Cleaning the inhaler to prevent clogging and properly priming the albuterol HFA inhaler are very important to make sure that the medicine sprays from the inhaler so you can breathe it into your lungs. Each albuterol HFA inhaler comes with directions for washing, drying the mouthpiece (part that goes in your mouth) and priming. There are some differences between brands of inhalers, so you will need to follow the directions that come with each inhaler.

What should I do if I have problems with my albuterol HFA inhaler?  

First, remember that the force of the spray from the albuterol HFA may feel different. Make sure you wash, dry, and prime the inhaler as described in the directions that come in each package. If you have problems using your albuterol HFA inhaler, talk to your healthcare professional as a different product may be right for you.

If the spray feels different, how will I know if my HFA inhaler is working in the right way?  

It is important to remember that it is the deep breath that you take with each puff that gets the medication into your lungs, not the force of the spray. The spray from an albuterol HFA inhaler may feel softer than the spray from an albuterol CFC inhaler but this will not affect the amount of drug that you breathe into your lungs. The spray from an albuterol CFC inhaler often hits the back of the mouth. The spray from an HFA inhaler is a fine mist that may actually be easier to breathe into your lungs compared to a CFC inhaler.

The HFA inhalers cost more than the CFC inhalers. What can I do if it's hard for me to pay for my HFA inhaler?

  • Talk to your healthcare professional about programs to help patients get medicines they need.
  • Some drug companies have patient assistance programs that make medicines available to patients at no cost, or at a lower cost.
  • Some patients may be able to get help paying for medicines from the Centers for Medicare & Medicaid Services.

Is it safe to buy HFA inhalers over the Internet?  

Buying your medicine online can be easy, just make sure you do it safely. The Internet makes it possible to compare prices and buy products without leaving home. But when it comes to buying medicine online, it is important to be very careful. Some websites sell medicine that may not be safe to use and could put your health at risk. For more information please see our guide: "Buying Prescription Medicines Online: A Consumer Safety Guide."


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