New Year’s Day 2009 will mark the beginning of a new era for asthma patients in the United States. On that day, chlorofluorocarbon, or CFC, inhalers will become illegal to sell or manufacture, and only hydrofluoroalkane, or HFA, inhalers will be available for purchase.

The purpose of the transition is to eliminate the harm to the ozone layer caused by CFC inhalers. HFA inhalers have been proven to be safe for the environment and just as effective at treating asthma symptoms. However, there are differences between the two inhalers that asthma patients and their families need to understand.
 
Different delivery, same medication
At Children’s, Christine Wagner, program manager of the Comprehensive Asthma Center, and Robin Brown, program manager of the Asthma Management Program, are educating patients and families about the upcoming inhaler switch. One of the primary messages they communicate is that while propellants are changing, the medication is not.

“Patients need to understand that the same active ingredient in CFC inhalers is used in HFA inhalers,” Wagner said. “The main thing changing is the method of delivery, not the medication. It is like Tylenol going from a tablet form to a gel capsule.”

Patients transitioning to HFA inhalers will immediately notice the difference in the taste and delivery of the medicine. While CFC inhalers shoot a robust spray into the back of the throat, HFA inhalers release a softer mist into the mouth that may be perceived as delivering less medication. The inhalers deliver an equal amount of medication; HFA inhalers just produce finer particles that are easier to inhale.

Each brand is unique
Another difference between CFC and HFA inhalers is that HFA inhalers have to be primed. That means a certain number of sprays must be released into the air before using the inhaler. Certain brands not only require priming before first use, but also after a couple of days of non-usage or a jarring impact.

Cleaning methods and cost are also dependent on the individual brand. Understanding the differences between the brands will help determine which to choose.

“Each HFA inhaler has unique characteristics,” Brown said. “So, it is important for you to seek your health care provider’s advice on which inhaler will work best for you.”