They look, taste and feel different, so Dr. David Skoner understands why some of his patients are wary of a government-mandated change in "rescue" asthma inhalers.
"People that come in to see me, they're frightened" of the change, said Skoner, director of allergies, asthma and immunology at Allegheny General Hospital on the North Side. "These are inhalers that they depend on to save them in an asthma attack."
The U.S. Food and Drug Administration is phasing out albuterol inhalers that use chlorofluorocarbons, or CFCs, to propel the medicine into asthmatics' lungs because those chemicals deplete the ozone layer. CFC inhalers are being replaced with inhalers that use a different propellant, called hydrofluroalkane, or HFA, which does not harm the environment.
The transition must be made by Dec. 31, 2008, and area pharmacies are switching.
"We're phasing it out because we have to," said Tom Riley, a pharmacist at Lebanon Shops Pharmacy in Castle Shannon. The pharmacy expects to complete the transition in the next few weeks. "We're running out of stock" of the CFC inhalers, he said.
Giant Eagle is phasing out CFC inhalers, and its pharmacists have started telling customers that they need to talk with their doctors about switching to the new type, said spokesman Dick Roberts.
More than 12 percent of Pennsylvania adults have asthma, compared with 7 percent nationwide, according to the U.S. Centers for Disease Control and Prevention.
Both types of inhaler deliver the same medicine -- albuterol -- to relax muscles that constrict breathing during asthma attacks. But there are no generic HFA inhalers available yet, and brand name inhalers cost about $30 to $45, twice as expensive as the generic CFC inhalers.
There are now at least four CFC-free albuterol inhalers available in the U.S., two of which have been on the market for at least four years.
Asthmatics should make sure they are comfortable with the HFA inhalers before they have to use them in an asthma attack, Skoner said. HFA inhalers have a less forceful, broader spray that tastes slightly different and doesn't feel as cold as the spray from CFC inhalers.
Russ Price was an early convert to HFA inhalers because he liked that they were more environmentally friendly. But the cost prompted him to begin using the generic CFC-containing inhalers more often.
"Especially when I was an undergraduate and in high school, I loved the fact that I was helping make the transition from CFC dependency," said Price, 25, of Squirrel Hill. "When I graduated from college and started paying for my health care, I noticed the price, and started using the generic inhaler more."
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