In accordance with an international agreement to reduce ozone-depleting propellants, manufacturers of many inhalers have changed the propellants in inhalers from chlorofluorocarbons (CFC) to hydrofluoroalkane (HFA). In addition, many asthma medications now have the most natural propellant -- you!
So called ‘dry powder inhalers', or DPIs, get medicine into the lungs when patients breathe in. For many patients this is easier as there is no need to time breathing in with pushing the pump to get the most medicine into the lungs.
The transition to all non-CFC driven inhalers is set to be in place by the end of December 2008.
Differences between CFCs and HFA inhalers
By appearance and function, there is little difference between CFC and HFA inhalers. Some patients find that they don't get the same effect with the same medication delivered with a different propellant, but this is a small minority of patients.
In some ways, the newer HFA inhalers may be better at delivering medication to the lungs. Even using the best technique, under the guidance of a respiratory specialist, only about 30% of the medicine that leaves the inhaler ends up deep in the lungs, where it needs to be to work. Most of the remainder stays in the throat and is swallowed or ends up in the air. Part of what determines how well medicine gets into the lungs is the size of the particles generated by the inhaler -- smaller is better. For some of the newer HFA inhalers, the medicine particles are a little smaller, so it is easier to get more medicine into the lungs using the same technique.
There is one downside to HFA inhalers that is important for most patients -- cost. While there are several generic inhalers for albuterol, for example, they are all CFC-driven. The new HFA inhalers remain ‘on patent', and therefore no generic forms can be made for several years. Whether paying a co-pay or out of pocket, this is sure to mean that most asthmatics will pay more for newer brand name inhalers than generics.
Essentially, there is no difference in efficacy between HFA and CFC inhalers, whether they are quick relief or controller medicines. If you need to switch, you will likely need a new prescription from your doctor, at which point you can ask him or her about any concerns you may have about the change.
What are your thoughts on switching inhalers? Is a heftier pay for these inhalers bothersome?