The ABCs of HFA

Everyone seems to be “going green” these days, and that’s a good thing. We’ve finally figured out that the health of planet Earth has a direct impact on the health of the people who live here.

Worsening air pollution, atmospheric ozone depletion, greenhouse gas emissions, overproduction of weed pollen, and more are all linked, and each one contributes to global warming.

Looked at individually, each of these environmental changes may seem small. But added together, they have a devastating effect on our environment and on public health—especially when it comes to people with asthma.

CFC, HFA, and MDI, Oh My!
Asthma patients have used albuterol metered-dose inhalers (MDIs) for more than 25 years. Often called “quick-relief” or “rescue” inhalers, these MDIs have traditionally used chlorofluorocarbons (CFCs) to “propel” the medication, albuterol, into the lungs. Unfortunately, these CFC molecules are getting into the atmosphere.

Although it may be hard to believe that the small amount of CFCs in a typical, quick-relief asthma inhaler could pose a threat to the environment, it certainly does. Scientists remind us that CFCs are exhaled into the atmosphere and make their way to the stratosphere. There, ultraviolet light breaks them down and causes ozone depletion. More than 20 million Americans have asthma and use inhalers all year long. That’s a lot of CFC.

Over the past 20 years, the United States has phased out CFCs in nearly every type of product. The makers of medications using CFCs were allowed to phase them out slowly, but the deadline is fast approaching.

Now there is a safe, effective, and environmentally friendly alternative to CFC; it’s called hydrofluoroalkane (HFA) and all of the asthma MDIs can use this propellant instead of CFC.

In fact, the U.S. Food and Drug Administration (FDA) has mandated that all CFC-based inhalers be removed from the market by Jan. 1, 2009. This means that patients currently using quick-relief CFC inhalers will need to transition to quick-relief HFA inhalers as soon as possible.

Every other nation in the world has already replaced its CFC albuterol inhalers with HFA albuterol inhalers, and the U.S. in finally following suit.

There are already several alternatives for patients to choose from, so it’s a good idea to make the transition now, in 2008, before you’re forced to switch in 2009.

What to Expect from an HFA Inhaler
Even though your inhaler is changing, the medicine inside is not. HFA quick-relief albuterol inhalers are FDA-approved and are just as safe and effective as your current CFC albuterol inhaler.

While the albuterol inside the HFA inhaler is the same as the one in the CFC inhaler, there are some differences between the two—including taste and spray force—and you should anticipate these differences as you make the transition.

For example, the sensation of the HFA spray will be less forceful than what you may be accustomed to with the CFC inhaler. Additionally, HFA inhalers have specific cleaning instructions that can be found in the information provided with the product. If you have any questions, don’t hesitate to ask your doctor.

Don’t Wait—Transition Now
You can begin your transition by visiting the website of the Asthma and Allergy Foundation of America (AAFA) www.TransitionNow.org.

There, you can learn about asthma management, control, and HFA-based albuterol treatment options.

Make sure to discuss the HFA transition next time you visit your doctor. And when you think about transitioning, consider whether you find yourself using your albuterol quick-relief inhaler more than twice a week. If you do, your asthma may not be properly controlled, and you and your doctor may need to re-evaluate your long-term asthma management plan and whether you may want to consider other treatments.