There are some significant differences between chlorofluorocarbon (CFC) and hydroflouroalkane (HFA) inhalers which are important for asthmatics and people with lung conditions to know about. By law, CFC inhalers will be banned in the United States as of 1 January 2009, as part of an overall effort to reduce the number of CFCs in the atmosphere. As a result, people who are used to CFC inhalers will be forced to switch to HFA inhalers.
The concern with CFC inhalers is that CFCs are known to be damaging to the Earth's ozone layer. In the late 1980s, a variety of legislation was passed to reduce CFC production and use around the world, and in 2005, the Food and Drug Administration (FDA) established a cut-off date for CFC inhalers, encouraging people to make the switch early to get used to the new inhalers and to help the environment.
Both CFC and HFA are used in inhalers as propellants, gases which help to disperse the medication into the user's airways. HFA inhalers, however, have a much softer spray than traditional CFC inhalers, which can cause people to think that their inhalers are not working. When using HFA inhalers, a very long, slow breath is needed, and it is important to wait 30 seconds between puffs. A doctor should be able to demonstrate the technique for patients who are not familiar with HFA inhalers.
HFA inhalers require special maintenance and cleaning. Before use, they must be primed with several sprays, and some require priming every few weeks or so. A pharmacist should be able to provide instructions about how many priming sprays are required, and how often the inhaler needs to be primed. HFA inhalers also need to be washed every week; to do so, the medication canister should be removed, and warm water should be run through the mouthpiece, which should be allowed to dry completely before reassembling the inhaler.
Many consumers notice that HFA inhalers feel and taste different from CFC inhalers, which can be unsettling. Some asthmatics are also concerned about the use of ethanol in the production of HFA inhalers, because ethanol is typically made from corn. For people with corn allergies, it is very important to check on the ingredients used in HFA inhalers, or to talk to a doctor about options.
HFA inhalers also tend to be more expensive, although attempts are being made to bring the price down. For asthmatics with limited funds, several drug companies sponsor donations of their inhalers, and a doctor's office may have samples which can be used to get used to the new inhalers. Ultimately, making the switch will have a positive environmental impact, when one considers the millions of asthmatics who will not be releasing harmful CFCs into the air.