Asthma inhalers now more eco-friendly

By RANDY GRIFFITH
The Tribune-Democrat

December 31, 2008 09:20 pm

— Although he tried to ease them into the change, many of Dr. Patrick Gray’s patients were not pleased their old, familiar asthma inhalers won’t be available.
“I have gotten more complaints than I expected,” Gray said.
Beginning today, asthma inhalers go “green,” eliminating the less-expensive generic brands of rescue inhalers delivering puffs of albuterol.
Inhalers with chlorofluorocarbons, or CFCs, have been banned because of damage to Earth’s protective ozone layer. Inhalers must be powered by the more eco-friendly hydrofluoroalkane, or HFA.
Although it’s the albuterol that quickly opens airways during an asthma attack, the change in chemicals used to propel mist into the lungs has led to some fears, doctors say.
The medicine feels and tastes different, and that may be elevating Gray’s patients’ anxieties about the unfamiliar inhalers.
“There’s still significant confusion,” Dr. Harvey Leo of the University of Michigan’s C.S. Mott Children’s Hospital told The Associated Press.
“Patients will tell you, ‘I don’t feel the puff anymore.’ ”
Not feeling the “puff” may contribute to some patients’ feeling that the medicine is not as effective, Gray noted.
“Every patient has a certain amount of placebo effect,” Gray said.
If doctors give patients a green pill on time and then a red pill with the exact same dosage the next time, many patients will say one worked better than the other, he explained.
But the surprisingly large number of complaints has Gray wondering if more study is needed.
“I don’t know if the delivery is not as effective,” Gray said.
“There might be something to it.”
The change shouldn’t be a surprise. The Food and Drug Administration has long warned it was coming, and lung specialists have spent the past year easing many of the nation’s 20 million asthma patients – as well as millions of emphysema sufferers who also use albuterol to ease breathing – into it.
But The Associated Press reports industry figures show that in mid-November, 20 percent of all albuterol prescriptions still were being filled with CFC versions.
The CFC-free options: GlaxoSmithKline’s Ventolin HFA, Schering Plough’s Proventil HFA and Teva Specialty Pharmaceuticals’ ProAir HFA all contain albuterol.
Also, Sepracor’s Xopenex HFA contains the similar medication levalbuterol.
Albuterol inhalers are for emergencies, for quick relief of wheezing.
Patients also need daily medication to control their asthma and prevent flare-ups.