Deadlines for other inhalers to go 'green'

Published: Tuesday, Dec. 2, 2008 12:16 a.m. MST
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Patients with asthma and other lung diseases should stay tuned: Quick-acting albuterol inhalers aren't the only lung medicines poised for changes because they're powered by ozone-damaging chemicals called CFCs.

The most-used daily medications used to prevent asthma attacks already are CFC-free, and all albuterol inhalers — the kind used to treat attacks — must be by Dec. 31.

Other types of CFC-containing inhalers will be phased out later.

The Food and Drug Administration has proposed December 2009 as the deadline for seven prescription-only inhalers to either go CFC-free or quit selling. They include:

• Cromolyn and nedocromil, a separate family of drugs used to prevent wheezing, often in connection with allergy exposure.

• Combivent, a combination of albuterol and ipratropium commonly used by patients with chronic obstructive pulmonary disease or COPD.

• Two additional quick-acting alternatives to albuterol, metaproterenol and pirbuterol.

• And two corticosteroids, inflammation-reducing drugs, called flunisolide and triamcinolone.

While a final decision is pending, the FDA says that deadline would give sufficient time to reformulate and that there are good alternatives for each category if the manufacturer chose not to.

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Also, December 2011 is FDA's final deadline for a nonprescription CFC-containing inhaler, epinephrine, to end sales or go CFC-free. The decades-old epinephrine inhaler is used by a small fraction of asthma patients for quick relief of wheezing, although it is not considered standard of care.

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