Switch from CFC inhalers now; alternative HFA products need more
maintenance
Pharmacists should educate patients about the care and
effectiveness of HFA products.
FDA announced a Public Health Advisory to alert patients and their
care providers about the need to switch from chlorofluorocarbon (CFC) to
hydrofluoroalkane (HFA) metered-dose inhalers (MDIs) and to educate
patients about the proper care of the alternative products.
FDA’s Deborah Henderson, MSN, Senior Advisor, Office of
Executive Programs, Center for Drug Evaluation and Research, stated
during a press conference that FDA had heard from its stakeholders that
patients and caregivers needed more information about HFA inhalers. The
agency has responded with a consumer article, question-and-answer
information sheet, podcast, and e-mail blast to stakeholders on the
subject in addition to the Public Health Advisory. FDA’s resources
are available at the link below.
Henderson said that although a generic version of the HFA inhaler is
not yet available, there are adequate supplies of the four brand-name
HFA products and help available from organizations such as the
Partnership for Prescription Assistance for low-income patients who may
not be able to afford the new inhalers. According to an FDA news
release, three HFA-propelled albuterol MDIs have been approved: Proair
HFA Inhalation Aerosol (Teva), Proventil HFA Inhalation Aerosol
(Schering-Plough), and Ventolin HFA Inhalation Aerosol
(GlaxoSmithKline). In addition, an HFA-propelled inhaler containing
levalbuterol, a drug similar to albuterol, is available as Xopenex HFA
Inhalation Aerosol (Sepracor). Keep in mind that all of the products are
“BX” rated and may not be substituted for each other.
Tell patients switching to HFA inhalers that the new products contain
the same medication as CFC inhalers but need more care because they do
not use the same propellants. The HFA actuator must be cleaned under
warm running water once a week; if it is not kept clean, it can become
clogged and the albuterol will not be delivered. The devices also need
to be “primed” before initial use. Inform patients that each
time they receive a new HFA inhaler, they should press down at least 3
to 4 times to prime the device. CFC inhalers did not need to be cleaned
because CFC is itself a cleaning agent. Reassure patients of the
drug’s effectiveness, even though the spray may taste different or
not feel as strong as that from a CFC inhaler.
FDA decided in 2005 to end the production, marketing, and sale of all
CFC-containing albuterol inhalers by December 31, 2008, as a result of
the Clean Air Act and the Montreal Protocol on Substances that Deplete
the Ozone Layer.
Web links
Related resources on www.pharmacist.com
Carli Richard (crichard@aphanet.org)
Posted June 3, 2008, 4:00 pm EDT
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