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Asthma med inhalers to have no CFCs by 2008

The increased cost of the alternative HFA inhalers is one of the central issues in the transition.

By Stephanie Stapleton, amednews staff. May 9, 2005.

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A government-ordered switch to more environmentally friendly albuterol metered dose inhalers means that physicians will have to help patients adjust to the change but also will give doctors the opportunity to stress the importance of asthma control.

The official countdown for this transition began March 31 with a Food and Drug Administration final rule directing that albuterol MDIs containing chlorofluorocarbon propellants must no longer be produced, marketed or sold in the United States after Dec. 31, 2008.

"To a large extent, the transition has already begun -- at least with inhaled asthma controller medications," explained Paul V. Williams, MD, a member of the American Academy of Allergy, Asthma and Immunology Pharmacotherapeutics Committee. Some commonly used controller medicines, for example, are only available in HFA or dry powder inhalers. Albuterol is the only asthma treatment largely still used in a CFC preparation even though HFA alternatives have been available for years.

With a date certain now set, physicians will find themselves doing more and more patient education on the topic. "It [also] means rewriting a lot of prescriptions," said Dr. Williams, a clinical allergist in Mt. Vernon, Wash.

The use of CFCs in consumer aerosols has been banned in the United States since 1976 as part of the Montreal Protocol on Substances that Deplete the Ozone Layer and the Clean Air Act. But newly produced CFCs have been allowed for certain essential medical uses, such as albuterol MDIs.