Go Green! Switching inhalers for the Environment
Yes it's true, as of January 2009 most of the inhalers we prescribe for COPD, Asthma and other lung diseases will be replaced. Your old CFC inhaler will no longer exist next year. Physicians like me will be telling all of their patients to switch to HFA-propelled albuterol inhalers among others and here is why:
1. Hydrofluoroalkane (HFA)-propelled albuterol inhalers will replace chlorofluorocarbon (CFC)-propelled inhalers in the United States after 2008.
2. CFC inhalers contribute to the depletion of the Earth's ozone layer.
3. Three HFA inhalers have already been approved by the FDA: Proair HFA Inhalation Aerosol, Proventil HFA Inhalation Aerosol, and Ventolin HFA Inhalation Aerosol.
4. In addition Xopenex HFA Inhalation Aerosol is currently being rolled out.
5. Manufacturers have been increasing production of HFA albuterol inhalers so an adequate supply should be available
6. HFA inhalers may taste and feel different than the CFC inhalers. Additionally, you must prime and clean HFA-propelled inhalers to prevent buildup of the drug in the inhalation device, which can block the medicine from reaching the lungs. Each HFA inhaler has different priming, cleaning, and drying instructions and hopefully you will be counseled on this before using it (what a hassle I know).
Dr O.
Categories: News
Support Groups: Asthma, COPD & Emphysema, Environmental Allergies, Lung Cancer, Pulmonary Fibrosis, Pulmonary Hypertension, Sarcoidosis, Sleep Apnea
17
CFC inhalers were replaced in UK last year. I would prefer a pump action inhaler rather than any aerosol oersonalloy as this too causes unecessary toxins more specifically in the body.
By Breathes August 18, 2008 2:28pm
16
Thank you Dr.Orrange for passing along this information with us here. I always wondered about if the use of inhalers could in fact be effect the environment such as the o zone?
By Sandra78 July 28, 2008 9:48am
15
I agree with Orsonwelz on this, Dr. O. I am all for going green on my arenas, but we are talking about the respiratory health of many people. The lost of an adequate rescue inhaler may send me to the hospital or kill me. It is very troubling that our medication is being tampered with. Who has advocated for us? Isn't that the job of the medical associations? What happened that made this bad law go through? The other rescue inhalers don't help me. What are people like me going to do?
By RonaS July 14, 2008 1:22am
14
Thanks Dr. O!
I read answer 9# but this whole issue annoys me just the same. And while I won't miss these in aerosol products either, I think some exception to an overbearing rule should be made.
By orsonwelz July 7, 2008 12:31am
13
Hey Orsonwelz
I appreciate your comments...read answer # 9 to this blog. This was to comply with the Clean Air Act and organizations (AMA, ACP, etc) could no longer argue for medical necessity when an option (HFA) came along. Remember we dont benefit in any way shape or form from this...but think of the issue more globally...we all know CFCs have been banned for being not only bad for the environment but also as a possible culprit in some chronic illnesses when they were included in aerosols so I wont miss them but I do appreciate the hassle...trust me.
By DrOrrange July 5, 2008 6:04pm
12
Dr. O-
I would've preferred if doctors actually advocated for their patients over an environmental action which: makes absolutely no sense, hurts patients who cannot take the new HFA inhalers, costs the patients more money, which will lead to less compliance and possibly increased deaths as a result of this, and will do little if anything to protect the environment in the end.
This is repulsive, cowardly cavein to drug manufacturers over patients forced to take these drugs.
My ultimate hope is this badly thought out decision will be reversed. For now, if doctors think this is such a great decision, let them take it - as they will also be forced to do and hopefully see the error of their ways.
This not "GOING GREEN" - it's "TURNING YELLOW" in the face of controversy and running like hell.
The AMA, AAAA and any and all other medical groups involved in this should be ashamed of themselves!
By orsonwelz July 5, 2008 1:27am
11
Thanks for that info LynnFD
By DrOrrange July 2, 2008 10:45pm
10
Making the switch from CFC inhalers to HFA inhalers has not been smooth in my house-Myself, my teen and my son have had adverse reactions to various HFA inhalers. Three out of the 4 HFA rescue inhalers contain ethanol, a known toxin causing bronco spasm in some asthmatics. I reacted the same to 3 such inhalers-increased bronco spasm,nausea, rash and chest pain. In response I researched and researched-if you are having the same problems, call your DR. try a different inhaler. File a Medwatch complaint with the FDA and google Save CFC inhalers and join us.
By LynnFD July 2, 2008 2:13am
9
Peter88: that was a typo sorry
Here is the answer to many good questions here
1) CFCs are being banned in inhalers in order to meet mandates authorized by the Clean Air Act and an international environmental treaty, the Montreal Protocol on Substances That Deplete the Ozone Layer. CFCs have been banned in aerosols (hairsprays, etc) for years but were allowed in inhalers because of "medical necessity". Because we can make HFA inhalers---CFC inhalers are no longer deemed "medically necessary"
2) An inhaler containing levalbuterol (similar to albuterol) is available as Xopenex HFA Inhalation Aerosol. HFA-propelled albuterol inhalers are not currently available in generic forms.
3) Here is what I found about the higher costs, etc: “Manufacturers of the HFA versions have created financial assistance programs and eased income restrictions for low-income patients. Physician, pharmacy, and manufacturer’s Web sites are also offering coupons for those who face a higher copay for these products."
4) Interesting fact! About 52 million albuterol metered-dose inhalers are prescribed in the United States each year, making them among the top 10 prescribed medications in the country
Dr O.
By DrOrrange June 27, 2008 6:27pm
8
Hashedlink brings up a good point. Are the CFC having enough of an impact on the ozone layer to even consider changing? What % of the depletion is due to inhalers?
By GoldfishCM June 27, 2008 3:40pm
7
Hi there thanx for that i am still a bit confussed if that aaplty to over here but hey good if it dose
But i already use cfc free and thats asmol so how dose that work or r these already avable here in aust
By lissy1982 June 27, 2008 4:12am
6
Thanks Peter on the comment about exhaling.
Hmmm...I wonder if a study was done to see how much CFC is actually being exhaled?
Deedee...I actually called around town about 6 months ago. Target still carries the old inhalers. But all are labeled that they will not be available after January. I experienced the same thing with my insurance with the new inhalers.
By hashedink June 26, 2008 11:54pm
5
My pharmacy has already switched to the new HFA inhaler, but my insurance co-pay increased to being almost equal to the price of the drug. Since there isn't a generic they hardly pay anything. Also I don't understand, if it wasn't good for the ozone layer, did the inhaler do damage to our lungs?
By deedeeT June 26, 2008 8:11pm
4
Xopenex is being rolled outby medicare??? I have been using it in my nebulizer for a few yezrs and have no problem. My supplier says I will have to subsatute it with albuteral whtich sends me tight inyo A Fib.
What's a body to do???
By janeinva June 26, 2008 10:45am
3
"Your old CPC inhaler"
CPC? Isn't that a typo and should be "CFC"? If not, what is CPC and why hasn't the abbreviation been explained?
By Peter88 June 26, 2008 8:41am
2
hashedink: if your spray CFC into your lungs, you will then exhale it into the atmosphere. It will then be free to travel up into the ozone layer and to react with this. So removing CFCs does make sense in reducing CFC emissions.
The excess packaging is a completely different issue. I suggest you write to the manufacturers about this in order to bring about change.
By Peter88 June 26, 2008 8:39am
1
So I have used the new inhalers and do not like them, plus they cost almost 2X as much. I have used albuterol CFC inhalers for over 25 years.
So I have a question:
If the CFC is being sprayed into my lungs (uugh, I know...but it works), how is that hurting the environment? I don't get it.
I wondered if maybe there is residue that is dispersed in the landfill upon crushing an inhaler, but that makes no sense. When the inhaler is empty, nothing comes out.
So then I wondered if it has to do with something in the production process?
And the new inhalers....it's been awhile since I tried one....but it seems there was more packaging and the inhaler is larger and has more plastic?
btw: Our family recycles a lot and are into green. But this inhaler decision made no sense to me from a CFC being dispersed into the environment standpoint.
By hashedink June 26, 2008 1:08am