Like it or not, the Food and Drug Administration (FDA) has made it official that seven classic asthma and COPD medicines will be phased out by December 2013. Yet there remain many medicinal options to help you maintain good control of your asthma, or maybe obtain even better control.
According to this press release from the FDA, the following are the affected products and there phase-out dates:
- nedocromil (Tilade), June 14, 2010
- metaproterenol (Alupent), June 14, 2010
- triamcinolone (Azmacort), December 31, 2010
- cromolyn (Intal), December 31, 2010
- flunisolide (Aerobid), June 30, 2011
- albuterol and ipratropium in combination (Combivent), December 31, 2013
- pirbuterol (Maxair), December 31, 2013
As you may have noticed, manufacturers have stopped making Tilade, Intal, Alupent and Azmacort.
The phase out is not because these meds no longer work for asthma and COPD patients, but due to "longstanding U.S. obligations under the Montreal Protocol" to get rid of substances that are believed to "deplete the ozone layer."
Basically, all of these inhalers "contain ozone-depleting chlorofluorocarbons (CFCs), which are propellants that move medication out of the inhaler and into the lungs of patients."
Azmacort and Aerobid are inhaled corticosteroids used to control the chronic inflammation in the air passages of the lungs, although better inhaled corticosteroids are now available, such as Flovent and Pulmicort Turbohaler.
Likewise, most asthmatics now get their inhaled corticosteroid fix in combination with long acting beta adrenergic (LABA) medicine like Serevent or Foradil via combination inhalers like Advair and Symbicort.
Intal and Tilade were mast cell stabilizers also used to treat chronic inflammation in the lungs. Newer medicines have proven to do the same job and better.
Alupent was the predecessor to Albuterol and Xopenex and pretty much outlived its usefulness anyway. It has more cardiac side effects than Albuterol. I remember my heart pounding after using it, something that rarely happens with Albuterol.
Maxair is another beta adrenergic medicine that I'm less familiar with, although it's been a nice alternative to Albuterol for many patients.
Combivent is the only medicine on this list that is still being used by a lot of patients, although not by many asthmatics. This is mainly a medicine to help COPD patients improve lung function. As you can see here, the makers of Combivent are working on a replacement medicine they hope to be available by the phase-out date.
Manufacturers could easily keep these products on the market by changing the CFC propellant to an HFA propellant, such as what occurred with Albuterol. However, the change would not be cost efficient with these seven medicines.
So you can see, most asthmatics shouldn't be affected so much by this phase out, as most of us are no longer prescribed them. However, as I can see by some of your comments to this q&a segment, some asthmatics are still taking one or more of these medicines, and are concerned.