Asthma Inhalers

Many parents of children with asthma may already have heard of this alphabet soup of abbreviations — CFCs, MDIs, HFAs, and ODSs.

They all have to do with a change in the type of metered dose inhalers (MDIs) being made to help reduce the release of chlorofluorocarbons (CFCs) into the atmosphere when taking certain asthma medications. Until recently, most MDIs in the United States, such as albuterol inhalers, contained CFCs — chemicals that propel the medicine in an inhaler into the lungs. But CFCs are ozone-depleting substances (ODSs) that hurt the environment.

Manufacturers are now making CFC-free inhalers, also called hydrofluoroalkane (HFA) inhalers, that do not rob the atmosphere of ozone.

“The FDA [Food and Drug Administration] and various manufacturers are reporting that the transition to HFA albuterol is occurring at a substantial pace,” says Pamela Wexler, an advisor to the U.S. Stakeholders Group on MDI Transition. This group is composed of nine leading medical societies and patient associations, including the American Academy of Pediatrics and the American Lung Association. “Estimates [near the start of 2007] indicate that as much as 50 percent of prescriptions are now being filled with HFA.”

What Parents Need to Know

What Is Happening?

  • Metered-dose inhalers (MDIs) contain ozone-depleting substances, chlorofluorocarbons (CFCs), and are being phased out.
  • All patients using a CFC-containing MDI will eventually need to transition to other products.
  • FDA has set a phase-out date for CFC albuterol of December 31, 2009.
  • CFC-free MDIs are safe and effective. Every other developed country is switching away from CFC MDIs without harm to patients.

What Can Patients Do Now?

  • Switch to CFC-free medications now that they are available.
  • Use this transition as an opportunity to talk with your health care provider about your asthma management plan.
  • Talk to your health care provider about CFC-free medications and non-MDI alternatives.
  • Talk to your doctor, nurse, pharmacist, respiratory therapist, or other health care provider when you receive a new inhaler to make sure you and your child know how to use and maintain it properly.
  • Check with your insurance provider to see whether the CFC-free inhaler is covered and if not, ask them to cover it.
  • Investigate ways you may be able to receive free and discount drugs if you are unable to aff ord your medication.

How Will the New Inhalers Work?

  • CFC-free products may look, taste, and feel a little different, but the FDA has found the new products comparable in safety and effectiveness to current products. Non-CFC MDIs are used around the world, and have been found to be safe and effective, without any adverse effects to patients.

What If I Cannot Afford My Medications?

  • New CFC-free MDIs may be more expensive than the CFC-containing products they replace. Pharmaceutical companies are committed to ensuring that no patient is denied access to medication because of the transition away from CFC.
  • There are numerous patient assistance programs to help people who cannot afford their medications. Some programs provide medicines free of charge, but have different eligibility requirements based on income. For patients who do not meet eligibility requirements for those free drugs but still need assistance, there are a number of programs that provide discounted drugs.

This article was featured in Healthy Children Magazine. To view the full issue, click here.