Albuterol HFA – What the hell?

As you all probably know, good old albuterol (with CFC’s) are no longer being made. No longer can we get an Albuterol MDI by Warrick for 9.95. Now we get “environmental friendly” pieces of shit for $20/each.
I recieved a phone call from a friend of mine who works in the People Republic of California. He told me that the state Mediaid (Medi-Cal) program decided (with their infinite wisdom) to take every albuterol MDI off of formulary. Thats right, he said no Ventolin HFA, no Proventil HVA, no ProAir HFA, nada.
You know whats covered? Xopenex HFA. 29.99 a pop too. What makes it even better? The company cant supply them fast enough to meet up with the demand of California! I laugh at him! Ha Ha! Oh, get this, they wont accept prior auths for albuterol either! Ha Ha^2! Guess patients are screwed there! Ha Ha^3! Who needs ‘clinical data’ or ‘efficacy’ or ‘studies’ when you put on your formulary the product that will give you the biggest kickback, er.. rebate. California (like Camelot) is a looney place!
So the FDA is saying that you cannot switch a patient from a CFC MDI to an HFA MDI without a new Rx. They are not equivalent and require a doctors OK to switch. They also say that all of the different HFA MDI’s arent interchangeable. I laugh at that too! You know how much bitching we would get if we faxed every doctor saying “Is it okay if we switch this CFC MDI to HFA MDI?” They’ll say “Are you retarded?”. I mean think about it; what doctor is going to say “NO! I DEMAND A CFC MDI! I KNOW THEY AREN’T BEING MADE! COMPOUND IT PUNY PHARMACIST!” Pretty retarded if you ask me.
But what do I know, I only have to hear the complaints.

79 thoughts on “Albuterol HFA – What the hell?”

  1. The same thing is happening here in Texas. Texas Medicaid only covers Xopenex HFA and will deny all prior authorizations for Albuterol HFA. Its retarded

  2. Has anybody figured out why Medicare Part D won’t cover Albuterol nebulizing solution? It is a Medicare Part B benefit. Our pharmacy isn’t a Part B provider, so the poor patient can get all their medicines from our pharmacy, except the nebulizing solution. Go figure the rational….

  3. We’ve already had fun with this one. We sent over 2 requests for new rxs for the albuterol hfa now that the albuterol cfc’s are being withdrawn from the market. On both notes faxed back, a lovely nurse says “you don’t have to request this as a change…it would be like switching tablets to capsules.”
    Gee, thanks nurse for all your input, let me fax you some information now that will prove you are a dumbass.

  4. What’s better here in the UK are the non-CFC Beclometasone MDI. These have different particle sizes and so are not interchangeable.
    You try telling that to a doctor, and explaining, AGAIN, how smaller particles means he’ll need to prescribe a smaller dose.
    Yes, he should have written it as a brand rather than as a generic, but he didn’t, and he won’t. “Speak to you next month” and we’ll have the same conversation-AGAIN.

  5. Now it’s bad enough we have different brand names on different sides of the pond (Prilosec/losec, zoloft/lustral), but having different bloody generic names takes the piss! Its salbutamol this side, why the hell is it albuterol the other side?
    And the FDA are bloody retards if they say different HFA MDIs are not interchangable. The ONLY MDI where any change of dose needs to be made is with Qvar (extra fine beclomethasone), which is twice as potent as other beclomethasone inhalers. Retards.

  6. Thanks for this post. I kept wondering why pharmacists were calling me asking to switch MDIs to HFAs, for the exact reasons you mention–they’re the same drug and you can’t get the old MDIs anyway! I generally consider pharmacists to be smart, helpful people so it perplexed me. Now I can blame those calls on the REAL problem–the government! Thanks! That Xopenex thing in CA is insane, by the way.

  7. It’s the same way in Mississippi! But somehow we got 6 of the CFC inhalers on our order yesterday! Guess we’ll be reserving those for Medicaid patients only..

  8. It’s not just the government. Every time one of our big insurance providers changes their formulary, my office gets flooded with these change Rx requests. Apparently I’m supposed to pay staff just to be available for the convenience of the insurers when they decide to switch 6000 Lipitor patients over to Zocor with Zero notice.

  9. The Albuterol Idiocy is worst for those of us who relied on “pure” albuterol. ALL of the current inhalers use ethanol or a corn-base to deliver the medication. I’m allergic to corn and totally intolerant of any amount of ingested alchohol. The only thing my allergist was able to suggest was that if I ever find myself in an emergency away from an ER, I should use my epi-pen to get to the ER! (He wasn’t happy to be saying this.)
    Before you tell me that you can’t be that intolerant – I’ve reacted to 0.001% alcohol content and minute amounts of aerosolized corn products. Yes, I can be that intolerant.
    It irritates me to no end that pharmaceutical companies and politicians are in cahoots to make effective patient treatment impossible. Too bad they are even trying to outlaw compounding which might have given me an alternative.

  10. I am right there with you. I have COPD. I have been on albuteral for 16 years. Recently they switched me to ProAir HFA. They say it’s the same thing! Bull Shit!!! I pay 40.99 with my insurance for this piece of shit. My albuteral was 7.00. If the albuteral is bad for the environment, doesn’t it make sense it’s bad for your lungs as well. I think we should sue the pants off the makers of this. It does not work!!!

  11. Xopenex HFA is WAY better than albuterol because 1-2 beats per minute less on average as a side effect is clinically significant and makes it worth the extra money. Sarcasm, cough cough…I wonder what official is getting paid off to keep that on medicaid’s formulary in California.

  12. Kathy, most Part D plans won’t cover the medication like you said but you’re free to bill to Part B. Does your pharmacy not do any Medicare billing? Could use Allwin Data and do it through your dispensing system very easily.
    Also, on Advantra you can process Part B covered items through their Part D plan using the group CHCPB instead of MDGHP. (Assuming this is the same per region..)
    I don’t get the Xopenex switch either. The basis of Part B reimbursement on the nebulizing solution was based on Albuterol which they claimed was clinically insignificantly different than Levalbuterol.. so basically they screwed people on Xopenex. Now they’re switching.. makes no sense!

  13. The same thing is happening in Kansas… I used Albuterol just a few weeks ago. Went to get a refill and they gave me this junk.. It taste like an otc I once used years ago… Which I could live with now I don’t know what to do… The cost for the refill was 45.00. What a drag.. I just hate it…

  14. Wait….the FDA says we can’t interchange CFC and HFA? Oh…well, I’ve been doing it at walgreens, so I dont think I’m gonna stop now. ^_^ Our inventory system even considers them interchangeable.

  15. I have severe COPD (20% lung capacity)and have been using two albuteral inhalers per month since 1995, mainly for rescue.I am also on Advair500/50 and Spiriva. In April,I went to the pharmacy for a refill, and they substituted with one inhaler of Pro-Air. My insurance said that is all that I had ever gotten. After talking with several people,the Pharmicist doing the same,my pulmunary doctor writing a new Rx, and my PCP writing new Rx’s and two to three Pre autoration forms, I am finally back to two inhalors /month. My first inhalor of Pro-Air did not seem to have much pressure right from the beginning, and it has failed working after about a week. Thankfully, my pulmonary doctor gave me some Proventil inhalors to fall back on. I have heard that there is a class action suit against Albuterol, but I have not been able to find a form or address .
    Do you know anything about this?

  16. You might recommend this site to your patients whose insurance doesn’t cover the HFA
    They can get one free inhaler and a voucher for 15 dollars off another one. I know it’s not much but we are using this to help our pharmacy’s patients, especially those who cannot afford the new product and those who keep an inhaler on hand for occasional/seasonal asthma relief.

  17. We need a choice!! I tried the new HFA inhaler and am still having problems from only five days of miserable use. It also tastes like hell and I had to use Prednisone from the breathing problems Proventil HFA caused me – it is toxic and this is bull….! When is the class action suit going to be filed because there needs to be one and I want to join. People will die from this new one and we need to cause enough pressure to bring the old one back!! The only thing cared about is the money here, not our lives!!


  19. This proair is a piece of fucking shit! Not only is it $30.00 more than proventil but it’s smaller and it tastes like shit! This is just another excuse for a big pharmaceutical company to make money off of people! Hey let’s blame it on the environment, (whatever!) They’re full of shit…With all the millions of things that damage the ozone and they decide to discontinue an inhaler…That’s absolutely fucking ridiculous! Like it’s going to make a fucking difference…I’d like to meet the group of people that came up with this shitty idea and smash a big terd in their faces!

  20. I’m glad to read that I’m not alone in my troubles with the new HFA inhalers. It’s been a month since I first used the ProAir HFA (didnt work) and then the Ventolin HFA. Only used them one time each and that was enough for me! After a month I’m still not breathing right, still coughing and still have that annoying little wheeze deep in my chest!! Thanks FDA! Way to go! Oh and yeah, I’m waiting to hear “class action lawsuit” as well because I can’t wait to join in. Maybe I’ll get some of the money back that I had to spend on the ER and Pulmonologist visits!!!!

  21. Angry Pharmacist,
    We’ve gotten hundreds of complaints mainly about IVAX ProAir HFA albuterol- a lot about Proventil HFA- very few about Ventolin (which has no ethanol, unlike the other two). I assumed ethanol was the main problem.
    In your opinion- is it possible that the HFA itself may be causing some problems?

  22. My wife just called, she went to pick up a prescription only to be told it was $40 after insurance, instead of the previous $10. This is all news to me, so thank you Mr/Ms Angry for clearing it up for me.
    I’ve been on Albuterol USP for years and my doc gave me a new Rx yesterday for a new HFA variety. Well, for the past week I’ve been “borrowing” a Proventil HFA from a family member and it’s pretty bad – doesn’t work as well, feels empty (after a week of occasional use) and leaves a nasty taste in my mouth, so I sure hope that isn’t what the new Rx was for.
    The pharmacist actually gave my wife one of the older ones when she almost choked at the price (we’re a little strapped for cash right now). He also said that they didn’t have many and that I should stock-pile the older ones by coming back every two weeks for a new refill until the Rx runs out.
    Now seems like a really good time to get serious about learning the Buteyko technique, which does really work it’s just a *lot* of effort.
    Clear breathing to you all!

  23. Damien,
    Be careful what you wish for, because you just may get it.
    The chances are excellent that your new Rx will not be filled with Proventil HFA, but with something much, much worse: IVAX/Teva ProAir HFA albuterol.
    Good Luck,

  24. I, too, am disgusted with this new HFA. I get my meds through a mail order pharmacy. The last time my doctor wrote my prescription for Albuterol, he apparently wrote “Albuterol HFA”. He didn’t say anything about it, so I didn’t pay any attention. Then, when the medicine came in the mail, it was Proventil, instead of the generic albuterol that I’ve been using for a dozen years. And it cost $30 instead of $10. That seemed pretty strange, but, hey! I need it to breathe! What am I going to do? Send it back? Refuse to pay? No. I decided to try this for a month or two, and then ask my doctor to rewrite the prescription next time I see him.
    I started using the new Proventil puffers, and right away I notice two things. They taste like crap, and they DON’T WORK! I am also on Advair and recently added Spiriva. The doctor wanted me to try to gradually cut back on the Albuterol, now that I’m on the other two. Cut back??? I end up using twice as much, because the stuff doesn’t work!!!
    So, right in the middle of allergy season, when my asthma is at its worst (on top of my COPD), I have this piece of crap that doesn’t work and runs out after about a week! It’s damned scarey when you are in the middle of an acute flare-up, and you can’t breathe, and the stupid inhaler that’s supposed to be helping you doesn’t work right!!! Can’t take another hit of Advair or Spriva… what the heck are you supposed to do??? Pass out and suffocate with the inhaler in your hand???
    I want to be kept informed about any class action suit that’s in the works. This stuff is killing me. The old albuterol worked much better. It wasn’t perfect, but at least it made it possible for me to manage my breathing.
    The only reason I found out about this site is that I got my second refill, today, and I called my mail order pharmacy to gave them hell about switching me from Albuterol to Proventil HFA, and then charging me triple for this piece of crap. They told me it was because my doctor wrote “HFA” on my prescription, so I started searching the internet to find out what “HFA” stood for. Now I see that I’m not the only one going through this experience, and that it is NOT the same medicine I’ve been taking for all these years.

  25. I’m doing some research for my Dad – he’s been using the CFC inhaler for years and has to fight like hell for it. I found a site that some of you might find interesting. It gives all kinds of info on the differences between HFA and CFC inhalers and provides a petition to keep the CFC propellants on the market. Good luck to everyone.

  26. across the big waters—
    i love our import/export laws–now just where in the hell is lipitor manufactured??
    so we can’t import ‘dangerous
    canadian drugs’ but if it comes from ireland it’s OK–hell, that makes absolutely no sense–how often do ya’ think the FDA visits that mfg facility—oh yea–i am scotch/irish !!

  27. I would like to start an organization to try and get people signing petitions that HFA inhalers not only DON’T work but they should be recalled since they clog constantly when I’m not even halfway through with them. Not only that but if they don’t have a propelant to them and you’re having an asthma attack, how are you supposed to get the medicine to your lungs?
    This is a serious problem for all asthamtics and should not be taken lightly, CALL your congressman, write them, CALL the manufacturers. DO SOMETHING. Don’t take this crap.

  28. My husband has emphysema and He was given a couple of samples of Preventil HFA and he got worse as the medication didn’t get to where it needed to be. Also since he needs the moisture in his lungs to be able to cough things up he realized that all the meds he was taking that are powdered are only drying up his lungs making it impossible for him to expectorate anything. I beg the government to realize they are killing all people that have a repiratory illness.

  29. albuterol 10.00 co-pay, alberteol hfa copay 50.00
    i wonder if the drug companies are behind this i took xopenex hfa and ended up with bronchitis-as usually happens when i switch my inhalers, and now im back on prednisone because i cant breath and cant afford to fill the new 50.00 meds. Im miserable

  30. I was switched to Proventil HFA last February and I even attended a focus group concerning the change from Albuterol CFC. The “official” reason being given for the change is that CFC inhalers are “bad for the environment.” So what are we as patients supposed to do. I have asthma and voiced my opinion at the focus group and to my doctors, that the new HFA inhalers are in no way “rescue inhalers.” In an extreme emergency they DO NOT clear the passageway effectively, and this could pose an extremely serious situation for anyone in need. I feel that my comments fell on deaf ears. I am still able to buy the old CFC inhaler but at a cost of $25 from the $10-$15 that I used to pay. And I know they won’t be around much longer. There has to something we can do — the new inhalers JUST DON”T WORK!!!

  31. Has anyone heard that ProAir HFA and Proventil HFA work differently since (according to this one doc) they have a different amount of the HFA propellant? This doctor is convinced that the ProAir isn’t as efficacious and refuses his scripts of Proventil HFA to be substituted for ProAir HFA. I’ve search PubMed, Ovid, and google but haven’t found a thing. Any thoughts?

  32. I couldn’t agree with you guys more. I’ve used the regular albuterol for 30 years….I’ve had chronic allergies and asthma since I was 10. Last week I got a bad case of bronchitis and my DR. wrote a new prescription for my inhaler. I wound up in ER last night getting a breathing treatment because not only did the ProAir shit not work, it made me worse. The pharmicist tried to tell me that it’s all in my head and that if I administered it correctly, I wouldn’t even notice a difference. I signed that petition and I sincerely hope it works.

  33. The petition to save CFC rescue inhalers (with well over 1100 signatures) has been suddenly and inexplicably closed by the petition’s sponsor. (see Viola Grosso’s June 19 post above for a reference to this soon-to-be-closed petition). She has quit the fight to save CFC inhalers.
    I was responsible for researching and re-writing this petition (until about a month ago)- and I know that many people will be upset about this.
    There is a Yahoo Group that I moderate dedicated to saving CFC inhalers at this url:
    My intention is to follow this situation by talking to numerous allergists and pulmonologists over the next year or so to find out whether the change from CFC to HFA inhalers (albuterol, atrovent, intal, combivent, etc.) is being well tolerated and accepted by their patients, or not.
    If it turns out that the overwhelming majority of asthma/COPD patients are ok with this POLITICAL ban of lifesaving CFC rescue inhalers (mandated by the Montreal Protocol and the Clean Air Act to “restore” the damaged Ozone Layer)- so be it. If not, we’ll know in a year or so, and we should presumably have sufficient MD support at that time to make a serious attempt to preserve CFC inhalers.
    I invite anyone who is interested in following this issue to join this Yahoo Group.

  34. Was searching the web for info on CFC/HFA. Glad to see that I am not alone.
    I changed from Albuterol CFC to Albutrol HFA a couple of months ago as the pharmacy could not get the CFC type I have used for years. The problems I see are:
    1) The HFA products do not work anywhere near as well. Since I changed I have had a cough. One day I had a real coughing fit while driving and could have had an accident. I am getting tired of the coughing. Very tired.
    2) The HFA product I use provides no sensation and no taste. You have no way of knowing if it has actually worked, esp as the new stuff does not work immediately. I called the pharmacist for advice but I can imagine that many will just keep puffing and overdose on Albuterol and in an ER
    3) Since there is no sensation or taste I am willing to bet that many users will keep using after the albuterol is gone and end up in crisis in an ER which would cost insurers a lot more than medicine which works.
    4) item 3 could be solved by inhaler with a counter but they will cost a lot more. I have good insurance and a decent job but I pity the young people with no insurance and the old people on pensions.
    5) I ask doctors and pharmacists for advice but people who do not are going to have a lot of problems
    6) There are going to be a lot of additional monetary and opportunity costs to the health care system just from people calling doctors, talking to their pharmacist. Add in all the office visits, ambulance costs, ER costs, and the cost to society will be huge. What really drives you nuts is realizing that the law restricting CFC’s does not kick in for 3rd world countries until 2010 and that includes industrial uses, refrigeration, A/C etc.
    Hint: instead of taking your anger out on your local pharmicist write your congressman and senators and tell them that you enjoy breathing and would like to keep breathing a while longer.

  35. Would you like to know what a Certain Very-large Store is doing about this?
    They pretty much cornered the market on the old Warrick inhalers; then they e-mailed their pharmacists telling them to remove the inhalers from the box (with its huge red label stating “IMPORTANT: INHALERS LIKE THIS ARE BEING DISCONTINUED DUE TO ENVIRONMENTAL IMPACT”), discard the package insert (with the same notice on it), label the inhaler itself and dispense it in a 40-dram vial. Apparently it is their desire to keep their customers unaware of the upcoming discontinuation of their inhalers. This will be costing them a bundle for vials, when spread out over six thousand-odd stores, so apparently they feel it’s worth spending the money to postpone the inevitable complaints. I wonder what they’re going to do when all the available R-12 is gone and they have a massive amount of patients all trying to switch at once (but that’s a problem for next quarter…)
    They stopped manufacturing new R-12 in 1995; about all that’s left now is what’s being sucked out of air conditioners in junked cars before they’re crushed. R-12 was ogiginal equipment through the 1993 model year: after that, they switched to R-134a, which is the same propellant that the new inhalers use. (And it worked middling well in cars designed for it, but the conversion kits for older vehicles work about as well as the HFA inhalers themselves, which is to say, not very.) Sooner or later they’re going to run out of junked pre-1993 cars, and then what?
    (Direct substitutes for R-12 do exist, such as R-414b, which can be used in A/C systems designed for R-12 without modification, so how come they can’t use that for inhalers?)
    Incidentally, when you type up a prescription for Proventil HFA at that Chain of Very-large Stores, the computer pops up a warning in contrasting colors, telling you that Pro-Air HFA is not A-rated to Proventil HFA and should not be substituted for it. If the script just says “Albuterol HFA”, of course, you can use whichever your professional judgment prefers, assuming their insurance will pay for it.
    And by the way, there’s another mfr out there who claims in their labeling to be able to supply the old CFC inhalers through 12/08, but they’re a bit pricier than Warrick…

  36. Shalom,
    Thanks for your very informative post. I have posted it in my Yahoo group which is at this address:
    and I hope that you accept my invitation to join this group immediately- we need someone with your level of expertise. If you are not interested, would you at least email me at : (please write “CFC” in the subject line- I assure you that I will guarantee your anonymity. I work with several FDA PADAC (Pulmonary and Allergy Drug Advisory Committee) MDs who insist on their anonymity being preserved (as well as other FDA PADAC MDs such as Dr. Nicholas Gross, Loyola-Stritch Professor of Medicine)- who has published a letter in the New England Journal of Medicine asking the FDA to postpone the CFC Albuterol ban until generics are available. He has also testified 8/2/07 during FDA public comments against the CFC Combivent ban. Our list of MDs opposed to the CFC inhaler ban is growing- and we expect it to rapidly increase in about one year when ALL pulmonary patients will have been exposed to the joys of HFA inhalers. But we need to hear from knowledgeable pharmacists as well, like yourself, and hopefully others.
    Shalom, one of your comments seems to contradict what the FDA/EPA has been saying.
    They say that except for medical inhalers- the only new CFCs the US requests permission for from the Montreal Protocol is for the Space Shuttle- are you saying that R-414b (which I assume is a CFC, not a HFA, if it’s a direct substitute for R-12), is currently being imported for air conditioners- or are you suggesting that air conditioners that already contain it should have their R-414b salvaged for inhalers? And is there no difference in quality control/purity for CFCs used in cars/air conditioners and CFCs used in medical inhalers?
    Please reply here, Shalom- and please email me personally- I’d like to get your opinion on the safety/efficacy comparisons between CFC and HFA inhalers from a knowledgeable, honest pharmacist. I’d greatly appreciate being contacted by ANY pharmacist- confidentiality, discretion, assured.
    Thanks very much,
    Art Abramson

  37. Lung deposition is higher
    with the HFA product than with the CFC product, so if you were taking 2 puffs each time, now take 1 puff. I was taking Proair with ethanol and was having shortness of breathe and heart palpitations from an albuteral overdose, because my doctor never explained the above. From reading other user comments Proair seems to be causing the most problems, mainly because of the ethanol. I swtiched to ventolin HFA (no ethanol) with the counter on it and I cut my dose in half, I’ve had no more problems yet and it’s been a week. I beleive this is a major conspiracy by the FDA. Create something that costs more, blame it on the environment, and get rid of all other means to help these people so they have no choice but to spend the additional money. And when I mean get rid of all other means I’m talking about the FDA trying to take Primatene Mist off the shelves. I can’t wait for a class action lawsuit to start up…..Hopefully this won’t cost too many lives.

  38. My doctor wrote my new prescription for Albuterol HFA,substitution allowed. I use mail-order for my prescriptions, so I went to my insurance website to compare the cost of the “old” Albuterol with the Albuterol HFA.
    For 3 months worth,the old one with cost me $20.00. For the new HFA, it will cost me $100!!!
    How am I supposed to afford the difference? I also take Advair and Singulair (which will cost me another $100 for 3 months). I don’t have that kind of money to spend. I am also on 2 other medications. Since we have insurance, we don’t qualify for help. I wonder what ppl do that have less than we do? GRRRRRR!!!!
    And I agree, the new HFA inhalers don’t work nearly as well.
    Should I have my dr rewrite my RX for Albuterol, or since substitution is allowed, will the pharmacy fill with reg. Albuterol if they have it?

  39. It has now happened to me in WI. My insurance would cover Albuterol for a cool $10 a prescription however with the switch insurance is now $40. Absolutely ridiculous!

  40. I too have found myself in the same situation. I used Warrick Albuterol, USP for more than 15 years. It was very effective and relatively cheap ($7-$10 copay). My Doctorthen informed me that it was being discontinued and switched me to an HFA equivalent. Equivalent my butt! Most of them were 50% as effective, 3 times the price, left me with a bad taste in my mouth and a ringing headache.
    While in Europe, I discovered Combivent (Boehringer-Ingelheim) as a replacement and it seems to work almost as well. It is of course a bit more expensive (my copays are now $25) and it is available online for about $40-$45 (full price).
    It truely amazes me that our governments have to interfere with our medical health all in the name of “Saving the Planet” while the medical industry sits back and counts the profit. /rant off

  41. I have had asthma my entire life and was very used to a CFC inhaler, they seems to have an alcohol burn to them maybe that was the ethanol?
    A few years back my Doctor switched me to the Provental HFA inhaler and it seemed much better, not so harsh to use.
    I have done very well on it.
    The last inhaler my Doctor let me try 2 of was the new Ventolin HFA inhalers that have the auto-counter on the bottom. These are simply wonderful for me, very smooth on the throat and for some odd reason I use it less than any previous inhalers I have ever used.
    My only gripe is that sometimes my drug store refuses to give me 2 per month on my inhalers and have always tried to over ride my Doctors prescribed dosages. I found out that is illegal for a pharmacy to do what the equivalent is of editing a medical prescription, and they can be sued big time for it.
    One time the drug store tried to give me some shoddy old CFC inhaler that kept making me sick, only for mt to discover later that the accentuator oils on it were peanut oil!!!!
    I am highly allergic to peanut and soy!
    Aa a precaution I decided to invest a bit of time with GlaxoSmith on the phone, their pharmacy expert said that it they used any kind of oils on their accentuators it would be listed in the ingredient document, so they promised me there would be none of those allergenic oils used in their inhaler.
    Maybe this is why the inhaler seems so soothing and smooth to me and my throat doesn’t get aggravated and I am using it less than any other inhalers i have had to use before.
    I have had asthma and used every astham drug out there and every inhaler made since the 50’s for over 47 years.
    Cheap inhalers might be great for your pocketbook but using them are not always the best thing for your lungs.
    Since inhalers are not a one type fits all, I wish GOODLUCK to everyone on their own search for the best acting inhaler for them.
    As far as I am concerned The Ventolin HFA with the built in counter so I am not sucking propellant after the medicine runs out is my ideal inhaler. I just love it!

  42. I absolutely agree with most here in saying that the new HFA does NOT WORK!! I am in the process of working with Congressman Heather Wilson in NM and the local television stations to get a headline story about this tradgedy that can cost many of us our very lives.
    Do the same: Contact your Congressmen and Senators NOW! The sooner we turn this around, the more lives will be saved. Period.
    Get a move on after you read these comments. Send me your names and info if you feel comfortable, so I can pass it on to our government officials working on this problem!

  43. A pharmacist showed me an article in pharmacy weekly advising them to tell their patients there is no difference. They should have to use this medication. The new stuff does not work.

  44. I am a 24 year old uninsured otherwise healthy athsmatic. I have been using a rescue inhaler since I was 5 and I have never had to use it multiple times a day unless i was doing sports, or was sick with broncitis. I recently was suprised when I had to go to the emergency room to get a new inhaler, because I finally ran out of the one I had for over a year. I was given some HFA piece of junk. This was three months ago, and I need to use it almost ten times a day. I have had three new inhalers since then, and I can’t imagine what this is doing to my body. I can no longer perform my work duties correctly anymore, and I don’t know what to do. I am 24 and I’m breathing as if I was a 97 year old cigar smoker. I can’t even sleep through an entire night without waking up in need for a rescue. Oh yeah, not to mention that these pieces of crap don’t even work within less than 5 minutes. I am willing to do anything for one of my old inhalers. It would last me for years and cost me thousands less. Please help me out. My job, health, sleep, well-being, and life depend on it. Pro Air is a huge business cop out and I’m not going to die over their retarded, save the ozone layer, tree hugging, screw everyone rhetoric. Forget this. I am actually afraid that this is going to be what kills me if nothing is done.

  45. I am so glad I found this site with the link to tinyurl. I, too, have had a lot of problems with both Proventil and ProAir HFS’s. I cough all the time, have breathing problems and find that I am unhappy that so, many, many people are haviing identical problems. I hope the petition is effective.

  46. {sigh}
    Well I’ve been looking and looking and I’ve come to the conclusion there is nothing I can do. I will die as soon as the MDI supplies run out. What is truly upsetting me is that because of this I�ve begun to truly live and appreciate life and started doing all the things I never had the nerve to do before which in turn has made me a much happier person. But because of it I sometime cry every single day because I know it will come to an end once I cannot longer find the supply of MDI. The new ones do not work and no agency (government or non profit) gives a Sh$t – I�ve contacted all of them. The thing I am told by doctors is that I can live off a machine for the rest of my life. Something that is not acceptable to me and pushes my beliefs beyond acceptable. So�. I�m living every week as if it is my last because it may well be.
    If anyone knows where I can get a supply of MDIs please email me

  47. Thanks to the goverment now I have to pick
    between haveing food to eat or hfa inhalers.
    Or maybe I should just cacel my drug coverage.
    Humana wants me to pay a 30.00 copay for a HFA albuterol inhaler that cost 43.00 without insurance because of the ozone layer.
    what the hell is going on here.
    thats like the goverment saying you have to put a safety coating on an asprin and charging 6 times the oringinal cost. what a bunch of crap.
    someone does not have it togather I am pissed.
    Edward Wegman

  48. discontinuing alburerol will kill off many innocent people. It looks like Alolf Hitler has returned to the Earth, and is running the FDA.

  49. regarding the new wonder drug, PRO-AIR INHALERS. What, are they out of their minds!!! The Warwick worked fine for my husband now he is so sick from the PRO-AIR and for what so the Pharmaceutical companies can line their pockets. What we paid $5 for we are also paying three times more for a terrible product that should not even be on the market! My husband has high blood pressure and this drug could have killed him and yes, I would of sued the company, something for them to think about.

  50. LOL I WISH Xopenex was around that price. Its $55 for me. No matter where you are in the US you can’t get Albuterol inhaler. The doctor switched me to the most pricy inhaler out there without telling me and the cheaper ones have sulfate in it that makes my asthma worse and makes me want to throw up instead. That’s not something I want to take in the middle of class. Coughing worse and throw up on something, joy. So I’m pretty much stuck with the $55 inhaler that I can only get because my parents pay for it, other wise I’d most likely die.

  51. I signed new, rec’d a confirm email, yet cannot sign in…huh? So, anonymous it is. (Perhaps, the Angry Pharmacist can hep this mama?)???
    Oh, well…I just left a comment on the AANMA website regarding this albuterol SCAM. Did y’all know this?:
    “…THE ALLERGY AND ASTHMA NETWORK MOTHERS OF ASTHMATICS (AANMA) and THE AMERICAN LUNG ASSOCIATION (ALA) have taken the tax-deductible contributions that pulmonary patients and their families have given to them in good faith over the years and actually used that money to PETITION THE FDA TO SPEED UP THE BAN ON CFC ALBUTEROL INHALERS!…”
    What an f’in TRAVESTY, eh? Yes, I’m among the millions who can’t get the good-ole Albuterol inhaler anymore…HFA is where it’s at–at a cost of $57.00 as opposed to $17.00 (qty=2) for me!!!
    #1, and most important, it DOESN’T WORK as all of your know; #2, I’m on SS Disability/medicare and simply can’t afford the bugger.
    I found a Canadian source that does fill “Salbuterol,” but I’m not sure if it’s the same ol’ HFA that the U.S. has. Anybody know??? It’s certainly cheaper…$40 bucks for (4) inhalers.
    Hmmmm…Wonderin’ if the Fatcats of the FDA and Pharmaceutical Co’s would turn around and give a sh*t if they were to view a video of me (and, probably you’all) wakin’ up in the middle of the night–and/or when triggered–gasping for air, going on hands and knees, chest muscles aching and barely able to find the phone for 911????
    Fatcats, indeed…They make me sick…literally…
    Good luck to all.
    I do have SOME good news. I took CHRIS’ advice (Comment of 2/2007) and–instead of not being covered AT ALL for albuterol and atrovent for my nebulizer? They DID bill my Part B Medicare (rather than Part D) and I will p/u the meds (1 box each) tomorrow for $11.93 and .55, respectively. Yeah!!! Thank you, Chris!
    ell 2008

  52. I’d prefer not to die before I’m 30. I thought breathing was a legal right, I guess not.
    Some of us just need some extra help but I guess Asthmatic-o-cide is not seen in the same light as genocide. I think all people who passed this stupid law/policy should have to run a couple of miles then try to breathe through a straw – then take that new P.O.S. Pro Air Inhaler to boot.
    Then we’d see what would happen!
    Didn’t know I’d have to pay $100 for ineffective medicine that makes me vomit, hurts my neck, may have caused lung damage & may have resulted in laringitus (first time in my life). Note to genius law makers & pharmaceudical companies, could you inform people first & let us vote on the issue? Especially when you’re probably just landed yourself with a couple of class action lawsuits from all the people that are going to now die due this ridiculous medicine change.
    If I die, I’m coming back to haunt ya’ll butts for this one. Wheezy & all! Thanks!

  53. There are 2 issues here. The first is the long-documented fact that CFC’s destroy the ozone layer in the upper atmosphere. CFC’s have been under a phase-out for 20 years or more. Check your hair spray, deodorant, furniture polish, and other aerosol products and you’ll find they have been CFC free for a long time. It has been know for a long time that CFC’s would have to be removed and the MDI’s reformulated. Learning to use the CFC-free MDI’s takes some getting used to. Those of us who have used spacers will probably have fewer issues than people who use the inhalers right out of the package.
    The second issue is the way that the FDA has allowed the drug companies to consider the HFA MDI’s to be “new” products. Bye-Bye generics! So now we have the “new” products and the various insurance company maintenance drug plans have to modify their formulary and only cover whichever brand name gives them the best deal. And if you don’t have a drug plan, you get to pay 10 to 12 times more than you were paying for the generic version.

  54. I’m so glad that I finally found this forum to vent (pun intended) my frustrations with this god awful hfa gauging. as if being depleted of air wasn’t enough. i am very much for protecting the environment, but has anyone even seen a study showing concrete data about the negative effects that cfc’s from ASTHMA INHALERS have on the ozone layer? nevermind the negative effects that these ceo’s flying around in corporate jets or driving hummers has on our planet. these corrupt harvard mba’s are creating one of the biggest scams since god knows when.
    the reality is that the drug companies are scrambling to find new revenue streams since their patents are running out all of their big money-making drugs and since it’s becoming more difficult to create drugs for diseases that are a) easy to cure (i use the word “cure” very loosely) and b)can create lifelong customers. the low hanging fruit is all but gone so what do the drug company execs do to keep their jobs and make sure that the shareholders are happy? they use their lobbying power and bribe some people in the fda and take a perfectly good, affordable, and widely-used drug like albuterol and make it illegal. and the best part is that their basically selling a person’s right to BREATHE. we literally haave NO OPTION BUT TO PAY. it’s not like you can boycott breathing.
    so now instead of having a $5 presciption, the pfizer’s, gsk’s, and schering-plough’s of the world can have $40 presciptions (yes, that’s how much it is at WALMART in CA…rite aid is $100!!!). Let’s do some math here…$40 / $5 = 8 TIMES THE REVENUE!! and i’m willing to bet that the manufacturing cost for this went up about .0005 cents per piece. THIS IS EXACTLY WHY THE MEDICAL INDUSTRY IS THE MOST CORRUPT INDUSTRY ON EARTH. Health CARE my ass. there is nothing healthy about these business practices. i would keep writing, but i’m getting worked up and since each puff of my inhaler costs 5 cents, I’m going to stop before i puff my way into the poor house.
    ps. it’s not like i’m a 4 pack a day smoker either. i’m 28 years old, in excellent physical shape, play soccer 3-4 days a week, eat healthy, don’t smoke anything, etc. i deserve the right to breath affordable air just like everyone else.

  55. Worse than the medical industry, worse than state Medicaid, is the federal government with all its environmental goons who demand that we put the environment above all else, including the health of its citizens. They’ve used hysteria to push their agenda to the detriment of people’s health.
    Someone above mentioned hair spray, deodorant, etc. as examples of products that have had CFCs removed from their formulation. The difference between those products and asthma inhalers should be obvious, and while some people may have not known the extent of the removal of CFCs, medical devices should have been exempt in the first place. One does not need hair spray or deodorant to live.
    The next time that you think the government will fix things for you, just stop and think of the number of people “fixed” by the ban of all CFCs, including medicinal uses. I have both personal and anecdotal evidence of the poor quality of HFA formulations. In my case, the alcohol used, I assume to enhance the delivery as a solvent, irritates my lungs while the actual medicine tries to open my airways. I end up in a constant state of airway irritation. It battles the good my steroid inhaler does.

  56. Ken, I just had to respond to your posting blaming environmentalists for this. I consider myself to be an environmentalist and I hate to break it to you, but environmentalists don’t have the kind of money of political clout to create something like this. Environmentalists are typically hippies (I’m not a hippie…I’m actually a capitalist) and hippies usually don’t have or care to have a lot of money. The environmental issue is merely a scapegoat for making this change.
    It was the FDA that made this change and I’m guessing it was after being prompted by the lobbyists for the Drug Companies. Big business has been using the term “Going Green” merely as a marketing ploy to fool most people into thinking they care about saving the environment. All these companies really care about are profits.
    Still don’t believe me, under the Bush Administration Big Business has thrived and inevitabley raped the consumer in countless ways (ie oil, electricity, healthcare, etc). Under Clinton, the US started to eliminate CFCs from household goods. Now, when this happened did the cost of a can of hairspray go from $2 to $16? No. So why is it that now the cost of an inhaler has, in some cases, gone from $4 to $100? I believe that it’s mainly because the Drug Companies knew well ahead of time that they could dramatically increase revenues because they have a stranglehold on the healthcare market AND they knew that the (Bush) government wouldn’t try and regulate this form of price guaging.
    So don’t blame the hippies for this. Blame those heartless, gutless, greed-driven drug companies.

  57. I called the FDA about the new HFA inhalers and how it doesn’t get the mediation to the air ways and lungs and they would like us all to go to their site and fill out their formal complaint form. If enough people do this perhaps they’ll take notice. The pharmaceutical companies usually rule though so I personally think we’re stuck with what they want to give us.
    There is a way to make the HFA inhaler work but many of you won’t like this method. I still smoke a few cigs a day but I’ve found that if I take a puff of my HFA inhaler and then immediately take a drag on a cigarette, I get results. It really works by getting the meds where they belong.
    If this method works for enough of you it might be just the thing to get the FDA to rethink what they’ve created. But only if it works for you, don’t fudge.
    Okay, now let all the anti-smokers have a go at me, I’m expecting it.

  58. Does anyone know who was the genius that allowed this to happen? This I believe is a national issue so who at the FDA was responsible for this. I have patients who cannot afford the new inhalers and now I need to put them on oral albuterol. One guy told me he is simply going to make a vaporizer and use the liquid. This same thing happened with Tussionex, 100 bucks a pop but the liquid hydrocodone that it replaced (because it was not approved for cough) was like 10 bucks. This is all about separating the consumer from their dollars. This shift is sucking A LOT of money out of patients pockets. And this is a life sustaining medication!!! FOR LOADS OF PEOPLE.
    I am very angry. Whoever thought this through and allowed it to happen should be beaten. I guarantee that if this was going to cost a mega corporation money it never would have happened. But since it increases the profit it is good for the economy and what is good for the economy is good for everyone RIGHT!!! Bastards…. I WANT NAMES.

  59. Virginia Medicaid and it’s wonderful HMO’s all cover different inhalers. Straight Medicaid covers Proventil HFA, Anthem HMO covers ProAir, Southern Health (Carenet) covers ProAir, OPTIMA covers Ventolin HFA, and Virginia Premier covers Ventolin HFA (I think). One of them covers Xopenex HFA only, but I can’t remember which one. It really pisses me off that every different medicaid plan covers something different. What a joke.

  60. I have had Asthma for over 15 years, and used CFC inhalers with no problems. Now, I can no longer get them, and I am forced to use the Pro Air HFA inhaler. Ever since my first use of this crap, five months ago, my blood pressure has spiked and my throat has become irritated, for starters. Not to mention that it does not work as fast or as effective.
    Let me ask a question. When the CFC inhaler is used, does the propellent actually make its way into the atmosphere after inhaling it into the lungs?
    In my opinion, a lot of people are going to die from using this stuff, or at least be forced to use other medications to reverse the side effects. Maybe this is just what the legalized “DRUG LORDS” are aiming for. Now…is the government (FDA) going to help? I doubt it, as they are mostly bought and paid for by the pharmacuticals companies. It still can`t hurt to sign petitions or contact congress reps.
    What is happening in this country? Have we become the new replacement for the old Soviet Union? Where has the voice of the people gone to?…or are we not people anymore, but just “Consumers”? LET`S GET THIS TAKEN CARE OF ASAP!!!!

  61. I have chronic asthma. THis Pro Air HFA inhaler does’nt help with my bronchial spasm. It’s not cost effective because the canister gets empty easily because this new HFA propellant is not doing its job in dispensing the medication quickly therefore you need to prime and waste puffs before you can get the actual meds. and it’s not as fast acting like the old Albuterol especially th Ventolin.This is considered as an emergency drug therefore- it suppose to be fast acting but it’s not!!! I haven’t use Prednisone for the longest time in my life and now I have to because this inhaler doesnt work. I used to have 1 inhaler for almost a year!This piece of s*** only last 3 -4 wks!
    Ozone layers my***! We cannot use the old ingredient because its harmful to our”ozone” layers and yet the tobacco companies are still legally allowed to produce cigarette and smokers are still free to smoke these carcinogens & release them in our ozone layers and also give us these 2nd hand smoke cancers!
    Geez! Dont mind me I am only an asthmatic and a nurse….

    1. On April 13, 2010, the FDA released a info sheet listing the last 7 asthma inhalers that used CFCs and their end date of production. I was under the imprssion as was my pharmacist that all CFC inhalers had stopped production. That is not the case. The good news is that one inhaler (Combivent) will contibue production until 12/31/2013. Combivent combines albuterol and Ipratropium and is commonly prescribed for COPD and asthma.

      The HFA inhaelrs I have tried (Ventolin, Proventil, and Xopenex) failed to provide adequate relief and frankly had me fearing for my life in an emergency situation. I have sense contacted my physician and they wrote a prescription for Combivent which I have used and will say that I feel much better until it too is removed from the market.

      Talk to your physician and see if it might be right for you. Hopefully, your insurance will cover it as without insurance, my pharmacy would have charged me $172.99.

      Good luck!!

  62. My asma comes and goes at times. The last year has been bad. I went two yease before I needed an inhalier. But this last year when I need one and asked for Warrick inhalier was shocked that it wasn’t available any more. Asked foe Ventolin hfc and was told that my Mass. Health would not cover it so they gave me ProAir. After a week ended up in E.R. with asma attack DUE to the ProAir. So told my Dr to script me Ventolin and I pay out of my own pocket. It cost me $35 but the Mfg had a $15 coupon. Ended up again in hospital after another attack. After three days they said I had COPD. Now using a nebulizer with Albuterol and Combvent inhalier. After almost two months my breathing almost back to normal.

  63. Sorry but if u loosers would learn to use the inhalers correctly, they’d actually work for you. And no, it was not the fda’s fault for banning cfc, that law was passed long ago and the medical community is the last to comply

  64. The whole premise for this debacle, the ozone layer depleting has been proven a fraud just like global warming. Chock up another one to stupid liberals with a cause.

  65. I have been using ProAir HFA for a year now. Has anyone else noticed that there doesn’t seem to be anywhere near 200 inhalations as is claimed on the label. I use it 20-30 times and it seems like it is running low. Piece of crap.

    I think every time a cow farts it causes 10 times more ozone depletion than using the old style inhaler.

  66. I picked up my new inhaler today, it is the Combivent Respimat, it cost me a $40 co-pay. Out of curiosity I asked the cashier to check and see how much the insurance company was being charged. When she came back with $386.00, I almost died! What a rip off! And I saw it coming all along. They took Primatine Mist out of production because it was “damaging the ozone layer” I could buy that for $20, and it always worked, so I could breathe.
    How about the millions of cars and trucks that kills the ozone layer, how about all the other contributing factors that damage the ozone layer. But no…they had to zero in on Primatine Mist, that helped people breathe! What a crock of shit…we know that it’s all about the money! Politicians and big pharma trying to pull the wool over our eyes. I am so pissed off with what they did! Don’t piss down my back and tell me it’s raining!!

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