Deadlines for other inhalers to go 'green'

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.

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.