Asthma inhalers becoming eco-friendly at a cost

Last warning: Asthma inhalers go green on Dec. 31, forcing patients still using the old-fashioned kind to make a pricey and even confusing switch.

The medicine inside these rescue inhalers - the albuterol that quickly opens airways during an asthma attack - isn't changing. But the chemicals used to propel that drug into your lungs are.

No more chlorofluorocarbons, or CFCs, that damage Earth's protective ozone layer. By year's end, all albuterol inhalers must be powered by the more eco-friendly chemical HFA, or hydrofluoroalkane.

The down side: The new inhalers cost more, $30 to $60 compared with as little as $5 or $10 for the disappearing generic CFC inhalers.

And patients face a learning curve. HFA inhalers must be used differently from the old-fashioned kind. The medicine feels and tastes different, sometimes alarming new users despite doctors' assurances that it works just as well.

"There's still significant confusion," says Dr. Harvey Leo of the University of Michigan's C.S. Mott Children's Hospital. "Patients will tell you, 'I don't feel the puff anymore.' "

Calls from parents unsure how to use the new inhalers, or even what they are, have increased in the past two months as more drugstores run out of CFC-powered inhalers and automatically switch people who'd been expecting a refill.

Lung specialists have spent the past year helping many of the nation's 20 million asthma patients - as well as millions of emphysema sufferers who also use albuterol to ease breathing - to switch to the new device. But industry figures show that in mid-November, 20 percent of all albuterol prescriptions still were being filled with CFC versions.

Albuterol inhalers are for emergencies, for quick relief of wheezing. Patients also need daily medication to control their asthma and prevent flareups.