The Inhaler Changeover

glad to hear your symptoms are better. mine too, knock wood. last time i used my inhaler was feb/march.

 

maxair....hmmm if it's an inhaler, they too will be switched to HFA...have you gotten any notices about that?

 

no I haven't, since I haven't needed to renew my prescription for it. I'm glad to hear that your symptoms are better!

oh me too! i hope my luck and both of our good health continues.

 

 

Good Day, my son has always used an Albuterol pump.  He's just like you, mild asthma & uses the inhaler in the winter.  Well, last week, I got a new prescription for Albuterol, only for the pharmacist @ Walgreens to tell me that it's no longer made!  I was caught off guard.  My insurance covers Proventil HFA 90 mcg (never heard of it).  Hope this helps him out. 

yeah definitely talk to your doctor.

 

and thanks for the bookmark!

Flovent has been HFA for a while. It works fine.

cheryl, i think you've voiced every asthmatic's fear about the change over from CFC to HFA inhalers.

 

i'm curious: what inhaler are you using and for what reason? how often are you using a rescue inhaler? have you tried a different brand with the new HFA propellant? have you talked with your doctor about yor concerns esp if you are still wheezing with the new HFA inhaler?

 

so many questions. ;-) 

 

The FDA is currently making a determiniation on permanently banning the Primatene mist. If you are passionate about saving the Primatene mist inhaler like I am, please send your comments to the following:

 

FDA will accept WRITTEN comments (no e-mail comments) through
11/19/07.

PLEASE send comments opposing this to the FDA.

The letter must include the following information:
Docket No. 2007N-0262 and RIN number 0910-AF92

They can be mailed to:

Division of Dockets Management (HFA-305), Food and Drug
Administration, 5630 Fishers Lane, rm. 1061, Rockville, MD 20852

thanks for the info!

hi matt,

thank you for your viewpoint. i just got an HFA inhaler today to try. we shall see. do you have asthma?

Thanks Sloane-

 

I had severe asthma from age 3 to 13 and moderate asthma afterwards until I was around 25.  

 

It was pretty rough, no doubt about it, I must have had 50 shots of adrenalin, multiple rounds of cortisone therapy, and was continually jacked up on large doses of ephedrine, per doctor's orders.

 

So I have an abiding interest in the subject.  I'm in my 50s now.

 

And when I heard about the surge in unexplained asthma related deaths, I decided to contact the attorneys for these companies and talk to them lawyer to lawyer.

 

I told them that getting rid of the Freon and the CFCs was a prudent step in light of what we know about the cause of death in most inhalation of propellant abuse cases.

 

And I told them that they were required to take steps after receiving my telephone calls.

 

Now, several years later, it looks like CFCs will be completely eliminated.  Several years ago one company took the lead in this regard; that is the company I spoke to.

 

mdubuque@yahoo.com

great advocacy story matt!

 

Have you had a chance to look at the mortality rates in the more recent past (the last year) to see if it has gone up again?.  I know my wife has tried the new ProAir HFA and her symptoms got worse.  Always nice to know that the rescue medication is there to insure a trip to the emergency room which is of course where all asthmatics need to be (either that or locked in a room with a nebulizer).  On top of the whole not being able to breath thing her legs developed very bad cramps which are only now beginning to subside after we were able to get ahold of an old CFC warrick inhailer.  And I know she is not alone in this (I have signed the petition at ipetitions too)

matt could you explain this comment?

 

"Always nice to know that the rescue medication is there to insure a trip to the emergency room which is of course where all asthmatics need to be (either that or locked in a room with a nebulizer)."

 

why should all asthmatics be in the ER?  

 

Looks to me like you are a big supporter of the HFA inhalers which for my wife and many like her have made the symptoms worse after taking them.  My wife actually got ill after taking the ProAir HFA inhaler.  Luckily we were able to find another pharmacy which still has a few CFC ones but we are very afraid of what will happen when they are gone.  The problem that the FDA et al keep ignoring is that when having an attack the asthmatic in question is unable to take deep breaths (see definition of an asthmatic attack) and that is exactly what is being asked of them.  Many of the new HFA inhalers also contain ethonol, and it seems that the higher the amount of ethonol the worse the results are.  The big problem with the testing used when they were checking these out is that the test was done by giving the medication then putting the asthmatics on an excersise routing designed to induce an attack.  While this will show that the medication works when it gets to the lungs before an attack, it does not show that it can get there DURRING an attack.  That is the place where the problem starts.  Then there is the whole thing about making sure that you have cleaned the delivery port.  The new medication will collect on the port and start to block it.  If you are having an attack the last thing you need is to be trying to think about when was the last time I cleaned this, what was that proper inhaler technique, etc.  When you cant breath your next thought is where is my next breath going to come from.  go to

http://www.ipetitions.com/petition/saveCFCinhalers/index.html

and read the comments from other people who have had problems (there were 217 this morning) and I cant find it anymore but I understand that there was an earlier petition out there that had thousands of signatures on it.

I had the "other" petition and yes, I did have over 1,000 signatures on it in a matter of 4 months. Petitions are a tricky thing I have found out.After it was verified, there were only 387 comments that were used for futher research. Many sign with fake names, emails and in general, after follow-up, were able to use some type of HFA inhaler. After several phone contacts and Doctors statements and media contacts, THE only path left was to close it and HELP patients Transition to the HFA inhalers. 1,000 sigs. or 10,000 will not stop the transition. I've had the petition closed since Aug. and I am still working on it. Proair is terrible, I became sick from it myself. Armstrong CFC does work...it's just not Warrick that we are all used to. So many things are still in the works right now. Good things are on the way. Ventolin HFA works good and Xopenex does too. Xopenex is a little cheaper and has a less jittery side effect. You have to try them to find the one that works for  you...we are all different. Start now and PLEASE don't wait until it's too late for treatment.

I USED THE OLD ALBUTEROL INHALORS FOR OVER 25 YRS.  I AM 67 NOW AND WORRIED SICK ABOUT THE NEW ONES WITH HFA.  SOMEONE SUGGESTED I ORDER FROM CANADA.  IT SEEMS THEY HAVE BEEN USING AN ALTERNATIVE ALBUTEROL FOR 3 YRS NOW WITH THE NEW HFA.  I ORDERED ONE........AND READ THE PAPER WITH IT.  IN IT IT STATES YOU SHOULD CONTACT YOUR DOCTOR FIRST (BEFORE TAKING) IF YOU ARE ALLERGIC TO EPHEDRINE OR EPINEPHRINE......(WHICH I AM), SO I HAVEN'T USED IT.  WE ALL KNOW THE ALBUTEROL IS THE SAME IN ALL THE INHALERS, BUT I DON'T KNOW IF THIS "REPLACED" PROPELLANT WILL BE IN THOSE SOLD IN THE U.S. (AS IN CANADA) AND ALSO HAVE AN ADVERSE AFFECT ON ME.  IS ANYBODY ELSE ALLERGIC TO EPHEDRINE OR EPHINEPHRINE AND TAKING THE NEW ALBUTEROLS BEING SOLD HERE NOW?  THANKS, BARBARA

Not a convient answer but maybe a helpful one. Purchase a nebulizer and get albutarol or xponex in liquid vile form. I think you can even get a portable nebulizers now. I rely on Flovent and servent now but need the rescue inhealer now and then. Seems we are being herded away from CFC. Not sure the ozone is the culprit.

ODDLY ENOUGH, I DID GO AND BUY AN OMRON PORTABLE NEBULIZER.  I WILL USE THE VIALS OF ALBUTEROL WITH IT.  HOWEVER, IT JUST ISN'T AS STRONG OR SUCCESSFUL AS THE OLD WARRICK BRAND INHALERS.  I ALSO UNDERSTAND THESE NEW INHALERS THEY SELL NOW CAN'T BE USED BY PEOPLE ALLERGIC TO "SULFA DRUGS".......(I AM)

I AM SURE THE AMT OF CO2 PUT INTO THE AIR FROM THE OLD INHALERS WOULDN'T HAVE HARMED A THING.  JUST AN OPPORTUNITY FOR PHARMACEUTICAL COMPANIES TO SELL THE NEW ONES AT TRIPLE THE PRICE AND ONLY LASTING HALF THE TIME AS THE ORIGINAL.

For those of you interested in why CFCs are going away, check this out. Hopefully it is as helpful for you as it has been for me.

 

http://ozone.unep.org/Assessment_Panels/EEAP/eeap-report2006-FAQ.pdf

 

There are some really cool links in the unep.org web site as well...Keep dancing...TangoLou

 

 

I have not.  And any rise is not necessarily attributable to new formulations.  The data is noisy.

 

On a personal note, I have found that substantially reducing my Hb1AC count has dramatically reduced my symptoms.  This probably will not hit the medical literature for another 10 years or so however.

 

 

Freon(brand name for refrigerants) is considered non-toxic.  It does however displace air, since it is heavier.  In large amounts, it can suffocate you in confined spaces.  I have worked with the stuff for years, and have never suffered from toxic side effects.

 

Ethanol, which is in the new inhalers, is shown to have a negative effect on some people.  Some asthmatics have an adverse reaction to ethanol.  How does this effect them?

Matt, I suspect more is at stake then the ozone which is causing this ban. I will say that HFA is a poor substitute from my perspective and I have moved to portable nebulizer. I to use it during work outs as excercse or cold thick air triggers constriction. One thing I know for sure is that ProAir is a poor poor inhaler. They have gone flat on me at an alarming rate. Four dead red ProAir HFA inhealers and one yellow proventil.  1 CFC still working in by medicine cabinet. At 20 with insurance a pop I feel like I am being fleeced.   

thanks for this link lisa to the petition...

 

clearly this transition is causing alot of anxiety and anger in the asthmatic community.

 

i just got my first inhaler last week but luckily havent had the occaision yet to try it out, yet.

 

i am nervous that it wont work properly but then again sometimes, in certain circumstances, my CFC albuterol inhaler didnt work either on my asthma.  

 

 quick question: how often are you using your rescue inahler? im just wondering how you tried every HFA inhaler?

Lisa

   It's funny that you would say that. I find it hard to believe that Art the man who has the above linked petiton is saying on forums that he uses XopenexHFA , he has found an inhaler that works! Why  did he not tell the rest of us? Should we try Xopenex HFA?

Hi TangoLou,

 

You correctly state that I have said on forums that I use Xopenex HFA (in between breaks with Warrick CFC- since Warrick feels much 'cleaner' to my lungs, superior to Xopenex HFA by far)- then you criticize me for not telling the rest of you? Was I supposed to take out a full page ad in the New York Times? Was I supposed to do a direct mail piece to 30 million pulmonary patients? Please forgive me for not notifying you properly.

 

My advice to all patients, based on petition feedback, personal experience, and updated MedWatch data is that they try Ventolin HFA first (it's the only HFA rescue inhaler without ethanol- a bronchoconstrictor, believe it or not. CFC inhalers did not use ethanol). Not everyone can handle Ventolin HFA- I can't. I had a severe two day flu-like syndrome (no fever- just wiped out) several days after I started it, followed by a 24/7 sore throat/headache/earache. By the time I connected it to the Ventolin, I had permanent tinnitus- this was five months ago.

 

Since then, we have imported from the FDA's database four years of MedWatch complaints- including over thirty mostly MD-reported fatalities where the HFA rescue inhaler was deemed  to be the primary (or only) suspect drug responsible for the outcome- along with many more severe outcomes. MedWatch complaints are underreported according to everything I've read.

 

It's worth noting that Xopenex HFA has a heavy concentration of serious cardiac adverse events- including many heart attacks. We know of at least one Duke MD who will not give Xopenex to any cardiac patients. We suggest, based on the above, that cardiac patients NOT take Xopenex HFA.

 

We don't know how many of each brand of inhaler was used during these four years, and MedWatch claims are raw, untested data. Also, we are relying on the FDA's data and we can not and do not guarantee the accuracy of their information. Having said that, Proventil was responsible for most of the reported fatalities. On Schering's homepage, they clearly state that "Rapid heart beat, vomiting, chest pain, and palpitation occurred more frequently with PROVENTIL® HFA (than with Albuterol CFC)." We do not recommend that anyone use Proventil HFA without first trying Ventolin HFA- and- if they are a non-cardiac patient- Xopenex HFA.

 

ProAir has generated more complaints on both petitions than any other inhaler. We do not recommend that anyone use ProAir HFA without first trying Ventolin HFA and  Xopenex HFA if they have no underlying cardiac disease.

 

CFC inhalers do NOT harm the ozone layer- the amounts are too small. Within one-two years we think pulmonary patients will revolt against this absolute stupidity and with or without the blessing of the Montreal Protocol, CFC inhalers will once again return to the US- and hopefully global marketplace as well. There is no rational reason for pulmonary patients to suffer with these inferior, dangerous inhalers.

 

Art Abramson

The NationalCampaign to Save CFC Asthma Inhalers

http://www.ipetitions.com/petition/saveCFCinhalers/  

 

P.S. If the link does not appear, google "save CFC" and the petition will appear at the top of the list

 

 

hmm i hadnt heard they stopped making liquid albuterol, anyone hear anything about this?

 

did you try calling the drug company to ask? or use your friendly google search engine?

 

Sloan, they haven't stopped making the liquid, just many of the manufaturers have stopped making the product.  The ONLY brand I have been able to find here in Michigan is the Dey brand which does not open my lungs as the Warrick brand would.  I contacted Shering-Plough but was only able to speak with a receptionist who said "its not being made anymore."  I attempted to contact Cardinal Health (the generick company manufacturing the product for Shering) who was manufaturing the liquid in a plant at Las Vegas and that plant is now closed. I haven't used google but will do that. 

 

JoAnne

hmm let us know what you find...