In the News

6 Months To Go: CFC Inhaler Phase-Out Deadline Looms

June 5, 2008

With only six months to go until the phase-out of CFC propellants for albuterol inhalers, the FDA notes that up to 55% of inhaler users have still not transitioned to HFA medications. “As respiratory therapists, it’s time to act and make sure our patients are educated and aware of the changes that will occur,” said Tom Kallstrom, Chief Operating Officer of the AARC.

Kallstrom, RRT, AE-C, FAARC, said that that there are several things that respiratory therapists should make sure their patients are aware of as the deadline for total phase-out of CFC inhalers hits on Jan. 1, 2009.

“Make sure patients are aware of this change. Many patients still don’t know about it or understand the differences between CFC and HFA powered inhalers,” said Kallstrom.

Important differences in the inhalers are outlined in a book written by the AARC last year, A Guide to Aerosol Delivery Devices. The distinction between the two types of medications begins on page 18.

Kallstrom offers these tips for respiratory therapists who are interacting with patients:

  • communicate with every patient to make sure they are aware of the phase-out.
  • tell them to talk with their physician soon to ensure that they are on medications that will be available after Jan. 1, 2009 and to make them aware when they are switched over.
  • tell your patients that the experience of using an HFA inhaler will be a little different. The sensation of the aerosol plume will be warmer and the volume will be less, so it will feel softer than the CFC powered inhaler. It needs cleaning to prevent build-up and the inhaler must be shaken with each use and primed.
  • assure them that they are getting the same medication and it’s working the same way; it just feels different.

“As therapists, it’s our obligation to inform and educate with every patient interaction,” said Kallstrom. “If they have questions, we should be the source for their answers.”

Differences in Characteristics between CFC and HFA MDIs
Physical Component Delivery of Dose CFC HFA
   From a near-
   empty canister
Variable Consistent
   With variable
   ambient temperature
Variable Consistent (to -20° C)
   Force Higher Impaction Lower (3 times)
   Temperature Colder Warmer (approx. 30° C)
   Volume Higher Lower
Taste Different from HFA Different from CFC
Breath-hold Less important with CFC More important with  HFA
Priming Important following short period of nonuse Longer time of nonuse allowed without priming