The Medical Letter on Drugs and Therapeutics
In Brief: New Propellants for Albuterol Metered-Dose Inhalers
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Med Lett Drugs Ther. 2008 Nov 3;50(1298):85
 Select a term to see related articles  2008   Airomir   Apo-Salvent CFC Free   asthma   CFC   Chlorofluorocarbon   HFA   hydrofluoroalkane   In brief   Issue 1298   levalbuterol   New Propellants for Albuterol Metered-Dose Inhalers   November 3   page 85   ProAir   Proventil   Ratio-Salbutamol   salbutamol   Ventolin   volume 50   Xopenex 

Inhaled drugs for asthma are available in the US mainly in pressurized metered-dose inhalers (MDIs), which require a propellant, and dry powder inhalers, which do not. The chlorofluorocarbon (CFC) propellants in MDIs are being replaced by hydrofluoroalkane (HFA) propellants for environmental reasons: CFCs contribute to the depletion of the ozone layer. December 31, 2008 will be the last day that albuterol MDIs using CFC propellants can be sold in the US. The FDA is expected to announce a termination date for other CFC-containing products in the near future.

Three HFA albuterol inhalers and one HFA levalbuterol inhaler have been approved by the FDA. None is available generically. HFA inhalers require priming — firing 4 puffs into the air (3 with ProAir) — the first time they are used, and after 2 weeks of non-use (3 days with Xopenex HFA).

In general, HFA sprays taste different, are less forceful, and are warmer and mistier than CFC sprays. Some patients may have to be reassured that they are getting enough of their medication, but actually the smaller particles of the HFA sprays may reach the lungs more readily than CFC sprays.

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