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Are Metered-Dose Asthma Inhalers Safe?

I heard that metered-dose asthma inhalers are no longer safe because of environmental concerns. Is that true? If so, does my child need a new inhaler?
Emily

Yes, that's true. It's now illegal for companies to make or sell CFC metered-dose inhalers. That's because these inhalers contain chlorofluorocarbons (or CFCs), chemicals found in aerosol hairspray or aerosol air fresheners that contribute to a breakdown of the earth's ozone layer.

CFCs are propellants that push or "propel" a liquid out into the air. In the case of asthma inhalers, a pre-measured dose of the medication albuterol is dispensed for kids experiencing severe asthma symptoms to breathe into their lungs.

New inhalers will also contain propellants — called hydrofluoroalkanes (or HFAs) — that work the same way as CFCs but have none of the environmentally harmful effects. Just like CFC inhalers, these inhalers are used as "rescue medication" by releasing a dose of albuterol or a similar drug to open up airways and relieve asthma symptoms such as wheezing, coughing, or labored breathing.

Before you talk to your doctor about getting a new inhaler, check to see if your child is already using an HFA inhaler. An HFA inhaler may be labeled "HFA" or "no CFCs." It also may note "CFC" in a circle with a slash through it. If you can't tell whether your child has a new inhaler, talk to your doctor as soon as possible because your child will need a prescription for a new HFA inhaler. You can't just take the old inhaler to the pharmacy for an exchange or a refill. So plan ahead and call the doctor's office now.

HFA inhalers are more expensive than CFC inhalers and range in price from $30 to $60, as opposed to under $25. At this time, there are no less expensive generic equivalents. If you need assistance paying for an HFA inhaler, talk to your doctor or insurance provider or contact the drug company to see if it offers a patient assistance program.

Once your child starts using the new inhaler, it may feel different from the old one. But rest assured, your child is getting exactly the same amount of medicine — and relief — from symptoms as before. Because the new HFA inhalers are a little different, you and your child will need to learn exactly how to use, clean, dry and prime it. Read the instructions that come with the new inhaler, and talk to your doctor if you have any lingering questions.

Have a question? Email us.

Although we can't reply personally, you may see your question posted to this page in the future. If you're looking for medical advice, a diagnosis, or treatment, consult your doctor or other qualified medical professional. If this is an emergency, contact emergency services in your area.

Reviewed by: Steven Dowshen, MD
Date reviewed: December 2008