Sunday, August 30, 2009 cac asks

Q: Intal Inhaler is being discontinued. What is a good replacement?

The Intal Inhaler is being discontinued. What is a good alternative to this inhaler? Some have suggested Tilade but that has been discontinued as well. I have been using this inhaler for years. I mostly use it before exercise, before going up tons of stairs or walking far, going out in very cold weather or on bad hot humid heavy air days. I am sorry to see it go. It doesn't work 100% but it does help enough! Hope someone can help. Thanks!

- A
- A
- A

Answers (10)

Rick Frea, Health Pro

9/ 2/09 5:36pm

Intal was once a top line asthma therapy for treating inflammation and preventing asthma and it was very safe. In fact, for about 15 years I used it. In fact, I used it way back in the 1980s when it had to be taken with a spinhaler which has been obsolute for quite a few years now.

With the advent of newer asthma wisdom, and the advent of medicines like Advair and Symbicort that are better at treating inflammation and equally safe, Intal is no longer considered a top line asthma therapy. Intal works rather well, but you may find that trying medicines like Flovent, Advair, Symbicort or Singulair may work even better than Intal at managing your asthma.

Personally, while Intal worked great for me for years, I find that Advair works much better.

At least now you have some options you can discuss with your physician. For more information, here is an excellent post you should read.

cac

9/ 3/09 3:34pm

Thank you for getting back to me.

I have tried Advair and was highly allergic to it. It made my throat close up and swelled my vocal cords. Is Flovent similar to Advair- meaning d0es it have the same ingredients? I am very nervous to try a different inhaler after my terrible experience with Advair.

Bee8

12/ 2/09 4:37pm

I was allergic to the powder in inhalers. The Doctor prescribed Advair spray inhaler for me and it works very good. I can breathe and go back to my excersises that I was doing. Maybe something in the powders as I also tried Advent powder inhaler and could not take it. I think Flovent is in my Advair as well as salmeterol. I find the combination very helpful and very seldom have to use my Ventolin.

Bee8

Eric B.

3/ 3/10 9:38am

The FDA is now advising against using ADVAIR and other LABA's http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm201003.htm

Michael Stephens

11/18/11 10:16am

Try the Symbacort instead or a newer drug called Dulaira. Most Insurance copanies will cover these rather than the Advair

cac

9/ 3/09 3:34pm

Thank you for getting back to me.

I have tried Advair and was highly allergic to it. It made my throat close up and swelled my vocal cords. Is Flovent similar to Advair- meaning does it have the same ingredients? I am very nervous to try a different inhaler after my terrible experience with Advair.

Anonymous

11/16/09 1:38pm

How can an inhaler containing steroids be "equally safe"? The NYT had an article just last week saying that long-term use of inhaled steroids has been implicated in other health issues. I am amazed at the degree to which steroid inhalers are being prescribed. If one has allergic asthma, minimize the baseline through exercise and diet (e.g. there is some form of soy in many food products nowadays, even though soy is a leading allergen). It is a hassle to read food labels but once one adjusts one's habits it is far easier. I can eat small amounts of soy now without getting an asthma reaction.

Elsewhere in this blog is a discussion of Nasalcromm, and that seems the safer and more promising alternative. The question is, as King Pharma says, how to deliver inhaled cromolynn sodium in an environmentally friendly way.

Thanks for listening.

Calirodan

1/ 2/11 10:14pm

"The question is, as King Pharma says, how to deliver inhaled cromolynn sodium in an environmentally friendly way."

If that's the concern, why not go back to the original spinhaler? Dealing with the capusules 3-4 times a day is mildly annoying compared to the modern inhalers, but it's not a big deal in the grand scheme of things.

Louise Marley

12/15/09 10:05am

People need to understand when they're inhaling steroids! There are long-term implications. I, too, wish there were another mast-cell stabilizing medication like Intal, which has no discernible side effects, at least for me.

Rick Frea, Health Pro

9/12/09 1:37am

Flovent is one of the two medicines in Advair. I can understand why you wouldn't want to try it, but you might want to talk with your physician. Advair has both Serevent and Flovent. Which medicine did you have the negative response to? The only real way to find out is to try Flovent (with your doctors permission of course). However, I can see why you wouldn't want to take the risk.

Louise Marley

12/15/09 10:07am

My physician says there have been problems with Flovent--especially reduced response to albuterol, if I remember correctly, sometimes resulting in deaths.

Rick Frea, Health Pro

1/ 4/10 4:56am

I have never heard of such a thing. I wonder what his source is.

Rick Frea, Health Pro

1/ 4/10 3:41pm

As a matter of fact, corticosteroids such as Flovent increase beta 2 receptor sites, which makes medicines like Albuterol work better not worse. Myth busted.

Eric B.

3/ 3/10 9:35am

The FDA is now advising against using ADVAIR and other LABA's

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm201003.htm

Calirodan

1/ 2/11 10:12pm

I tried Advair and found that it made me nervous and hyperactive. But I did well with Flovent.

I'd been nervous about using a steroid inhaler because when I'd used Asthmacort in the early 90's it had made me gain weight.

Still, I was disappointed when it became difficult and expensive to get Intal on my health plan. Intal had always worked well for me, had no discernable side-effects (which hadn't been the case with many asthma drugs) and I felt better using a medication that wasn't a steroid if possible.

2/14/11 1:39pm

I used Advair for 5 years. I quit. My spirometry measurements are the same as they always have been--they are measured when I get my allergy shots. I now have mild cataracts (steroids can cause cataracts and glaucoma) and I have had a lot of bone loss in my jaw (needed to have some bone graft material injected into my jaw). I also have osteoporosis. Steroids can cause osteoporosis. Hard to say whether or not these issues would be there, or be as bad, if I had not used Advair. I am 57.

jeffn1

9/13/09 3:39pm

Try inhaling Nasalcrom (sodium cromolyn). It seems to be working for me. I double the number of puffs from 2 to 4.

Good luck!

cac

9/17/09 2:28pm

Thanks for responding. I see 2 different types of the Nasalcrom-

1. NasalCrom Nasal Allergy Symptom Controller, Nasal Spray and

2. NasalCrom Allergy Prevention Nasal Spray.

Can you please let me know which one you are using? Thanks again!

belle

9/17/09 4:21pm

Hello,

I am also looking for a replacement for Intal. You mentioned Nasalcrom. There are two different brands of that product. Which do you use? Thanks.

jeffn1

9/17/09 8:31pm

I wasn't even aware there were two types. I am using:

NasalCrom Nasal Allergy Symptom Controller

Now, I am curious what the difference is.

Jeff

Linda Schorr

12/ 2/09 2:50pm

Do you inhale the Nasalcrom through your nose as prescribed, or through your mouth, as you would with Intal?

Linda Joy Adams

10/31/09 12:03am

For the @ 3 million of us in the USA that do not have allergy -related asthma; little is available. Medications that are antihistamine cause severe asthma symptoms and can be life-threatening. The pharmaceutical industry has had decades to come up with an alternative. When they said they did in the mid-90's many patients like me suffered severe reactions as the chemically- induced asthmatics were not included in the clinical trials. After, many deaths and hospitalizations and adverse reactions, those in authority , Congress gave a waiver, but still did not address the issue of FDA discriminating against my minority group of asthmatics. I am beginning the process of settlement negotiations with federal workers compensation. i will have to add in the amounts needed for added needs.

Since the inhalent is basically a saline wash for the lungs; isn't there some way of getting a minute vapor into the lungs safely without the use of propellents? I'm not a scientist, just a patient. I'll be asking my doctor about a salt water vapor(steam)! Linda Joy Adams (query my name on Bing or Dogpile and click on washingtonpost.com to go my personal page and read my story.

Adelaine Saria, Pharmacist

11/16/09 12:18pm

It looks like King Pharmaceuticals in the U.S. will not reformulate the Intal inhaler explaining its inavailability in the U.S. I have found that many Intal inhaler users are reluctant to switch or substitute their therapy with other asthma medications including Singulair or steroid-based therapies. If that is your situation, I would recommend seeking assistance from a mail-order pharmacy that offers international products. CanAmerica Global supplies Intal inhaler from the United Kingdom (http://www.canamericaglobal.com/products/Intal_Inhaler/5/) It has provided continued therapy for many Intal inahler users. CanAmerica Global offers a worldwide network of international pharmacies. CanAmerica Global and its pharmacies have been verified by the Pharmacy Checker Verification Program (http://www.pharmacychecker.com/ProfileRx.asp?PCID=514A367E-19BE-483E-9579-FCF6A3DC127B) As a pharmacist with CanAmerica Global, I invite you to contact us toll-free at 1-866-648-9142 to discuss your Intal inhaler therapy and discuss the most suitable continued therapy that best meets your needs.

Mark Miller

4/27/10 11:24am

A good alternative to Intal inhaler (cromolyn sodium) is Intal nebulizer solution. This product is available generically as Cromolyn Sodium inhalation solution, USP 20mg/2ml vials. The difference between the inhalation solution and the inhaler is that the inhalation solution requires a nebulizer machine. It is my understanding that the inhaler was discontinued from production by the manufacturer because laws had been enacted requiring removal of certain aerosol propellents in metered dose inhalers to save the ozone layer. Apparently it was cost prohibitive to re-formulate the Intal metered dose inhaler so the manufacturer stopped production....However, the nebulizer solution is converted to a breathable mist by a nebulizer machine and, so, uses no unapproved aerosol propellents. It is my expectation that the nebulizer solution should remain available as long as there is demand for it.

Mark Miller, RPh

Laura

5/10/10 3:32pm

I switched to the nebulizer form of cromolyn sodium two months ago after Intal was no longer available. It is working out reasonable well so far, but of course a nebulizer is a bit inconvenient since it has to be plugged in and takes about 5 minutes compared to seconds for an inhaler. Does anyone know if cromolyn sodium can be used with ultrasonic nebulizers? Ultrasonic nebulizers are portable and would take about half as long as the jet compressor nebulizer. I have a call into my phyisician, but thought others might be intersted in this topic.

Thanks!

Laura, 24 year user of Intal!

tanfan

5/17/10 1:56am

Yes, for a couple of months I used cromolyn sodium inhalation solution with an ultrasonic nebulizer, for the portability that you mention. However, I've since switched to Tilade inhalers, from Inhouse Pharmacy http://www.inhousepharmacy.com/asthma-allergy/tilade.html. These inhalers have worked out great for me -- better than the Intal inhalers, and better than the cromolyn sodium inhalation solution.

JAMES LEE

10/22/10 12:50pm

I just ordered TILADE from this company and used my credit card to do so.

It comes just like the old style discontinued INTAL inhaler.

Including shipping and w/their Oct 2010 10% off sale, 5 units of TILADE costs $112.50, much cheaper than the $89 per unit of INTAL still available from the UK on other websites.

The Meds come from the UK to the US.

Please know that their website is now : www.inhousepharmacy.biz

I too, very upset that INTAL was discontinued in the US, just hope TILADE works as well ! GOOD LUCK !!

JAMES LEE

10/22/10 12:52pm

I just ordered TILADE from this company and used my credit card to do so.

It comes just like the old style discontinued INTAL inhaler.

Including shipping and w/their Oct 2010 10% off sale, 5 units of TILADE costs $112.50, much cheaper than the $89 per unit of INTAL still available from the UK on other websites.

The Meds come from the UK to the US.

Please know that their website is now : www.inhousepharmacy.biz

I too, very upset that INTAL was discontinued in the US, just hope TILADE works as well ! GOOD LUCK !!

smith.utha

2/11/11 3:28pm

Intal is available from Canada. You can check out Intal Inhaler. Best prices but requires a prescription.

maybabies2

3/11/11 12:07am

why is it being discontinued? does it cause heart problems? because my 10 yr. old daughter has developed heart problems within the last 5 years which is after she started using this inhaler. I am very concerned.

tanfan

3/11/11 1:08am

It has been discontinued in the U.S. because King Pharmaceuticals, which is now part of Pfizer, and which holds the rights to sell Intal in the U.S., was not able to (or did not want to pay enough to) line up a manufacturer to make the HFA version of Intal once their prospective supplier went bankrupt, and once the CFC version could no longer be sold in the U.S. (and elsewhere) (ostensibly for environmental reasons).

You can read more about it here: http://www.in-pharmatechnologist.com/Industry-Drivers/Inyx-drama-highlights-crucial-need-for-due-diligence-on-contractors

As you probably know, you can currently buy Intal HFA that is not U.S.-sourced.

maybabies2

3/11/11 1:21am

thank you. I was concerneed because someone told me it was discontinued due to causing heart defects, and my 10 yr old daughter has been put on a transplant list for 2 years due to heart failure non related to birth. SO i just wanted to make sure. Thank you again.

Lori

tanfan

3/11/11 1:29am

You're welcome.

I sincerely hope your daughter can get the transplant she needs.

Grier

3/16/11 9:10am

Cromolyn Sodium is one of the safest asthma drugs on the market! There are no side effects. It is the only drug that works on early phase asthma. It works great for exercise induced asthma without increasing the heart rate. I've used it for over 20 years and had to fight to get put back on it when the MDI was no longer manufactured. You will need to use the nebulizer solution. It is on the "orphen drug list" so it will always be available. This drug has very little absoprtion into the body. It stays within the lungs. You do have to give it a good trial though. It takes at least a month to build up enough in your lungs to be effective.

AJsMom

8/26/12 4:41am

I researched the "Orphan Drug list" and found that the Cromolyn Sodium designation on the list is specifically for the Oral (Gatrocrom) and the Opthalmic use only; not for the lungs. We had been using the Cromolyn Sodium Inhalation Nebules (for the nebulizer) as a replacement for the Intal inhaler. Recently (8/2012) our pharmacy said this supply is exhausted and will not be replaced. Now we are back to the question at hand. I found the Intal CFC-Free from UK, but am not willing to try with a child (it is 5mg) and I've read many blog posts that it is too strong and caused immidiate breathing problems. Does anyone else have experience with this dose for children? The US Intal (by King) was 800mcg.

Thanks,

Krista

tanfan

8/26/12 2:24pm

I still see Cromolym Sodium Inhalation Solution nebules (20mg) available from Teva: http://www.tevausa.com/default.aspx?pageid=3559&audience=hcp&ProductName=Cromolyn+Sodium+Inhalation+Solution%2C+USP&BrandName=Intal%C2%AE+Inhalation+Solution. Maybe you can order them through a different phamacy? A couple of years ago, when I was taking them, Teva's regional distributor actually offered to call my pharmacy to tell them these nebules were available for order, when they claimed they were not. Don't know if this will be of any help (at least at a different pharmacy). Good luck.

Misty

10/ 5/11 2:20pm

My son is on flovent and singular. He took Intal before he played hockey and it worked wonderful. You can still purchase it in Canada with a prescription.

Q: Intal Inhaler is being discontinued. What is a good replacement?

Related Questions

Ask a Question