What are HFA inhalers?

Why does my inhaler say HFA?

HFA stands for HydroFluoroAlkaline. Back on December 31, 2008 the government pulled the plug on CFC (chlorofluorocarbon) containing inhalers and made HFA inhalers mandatory. This development arose out of concerns over the potential for CFC containing inhalers to damage our Ozone layer. Unfortunately the question about whether these inhalers REALLY did do any damage to the Ozone layer is now moot. Some examples of the new HFA inhalers include Proair HFA, Ventolin HFA and Proventil HFA. A steroid inhaler, Flovent HFA, also uses this new propellant.

CFC, and now HFA, are propellants (the ingredient that allows the medicine to exit the cannister as a spray or puff). CFC's were developed back in the last 1920s and early 1930s as wonderful alternatives to the previously used ammonia and sulfur dioxide (toxic and flammable agents). CFC's made for excellent propellants in asthma inhalers. There were reliable, available and inexpensive.

Will the HFA inhaler work as well as the CFC inhaler did? Probably. But there have been some reports of inneffectiveness, allergic reactions, and actually worsening of symptoms on these HFA inhalers. People allergic to corn have had trouble with them.

Prescriptions that use HFA as propellants:

  • Proair HFA
  • Proventil HFA
  • Ventolin HFA
  • Flovent HFA
  • Advair HFA


As a pharmacist I get asked about using an HFA inhaler by my patients all the time. Some had only ever used CFC inhalers and are concerned about switching. Here is my advice:

1) Try it. Really. In spite of what all the terrible reports say it probably won't actually kill you. Your HFA inhaler has the exact same active ingredient that your previous inhaler had. The only difference is the propellent.

2) Realize that the mist is going to be softer and taste different in the HFA inhaler, but these things don't necessarily make them evil.

3) Prime it. Clean it. Count it. Prime them first for them to work. Clean the plastic container frequently (mild soap and water is fine). Monitor your daily use. Actually, if you are having trouble keeping track of how many puffs you have used the Ventolin HFA comes with a dose counter.

Okay. That's it. If you want to vent about HFA ihalers, take action against the HFA inhaler mandate, or just read messages from other people venting you can sign the national petition to save CFC's!!

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Comments 9 comments

Kim 7 years ago

It's kind of a joke to expect someone having an asthma attack to successfully inhale a "softer" plume! The FDA got this one wrong!


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pharmacist 7 years ago from Whitinsville, MA Author

I agree with you Kim. This was a sad display of the politics of medicine, and the ones who get hurt are the patients.


john 6 years ago

Your "funny" quips are all in poor taste ! I am dying and yes hfa can kill and is. Big Pharma IS EVIL !


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pharmacist 6 years ago from Whitinsville, MA Author

Hi John,

Deeply sorry that my manner offended. May I offer any help or answer any questions that might assist you?

Sincerely,

Jason


Jefe 6 years ago

My Ventolin HFA is terrible. I have used it several times over the course of a few days with no effect. I almost lost consciousness during a run when my chest tightened and Ventolin did nothing. No matter how many puffs I take or when I decide to take them, there is no effect. My girlfriend can hear me wheezing before and after each puff. Not only does it have a funny taste, but the ABSOLUTELY TINY puff it emits comes out as fast as lightning. Well, I just woke up to an asthma attack and tried a few puffs of Ventolin with no effect. After a good 20 minutes of controlled breathing and relaxation exercises, I am able breath OK (not great) and it's time to finish my sleep. G'night!


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pharmacist 6 years ago from Whitinsville, MA Author

Jefe,

Sorry you are having a rough time with the Ventolin HFA. You may have gotten a defective one. I would suggest bringing it to the pharmacy to have them check it. Also, have a pharmacist or your doctor observe the way you use the inhaler, just to be sure you have the right technique. Finally, a spacer sometimes help. Aerochamber is one example. One more option would be to switch to Proventil HFA or Proair HFA. Hope something in this helps. Best wishes.


Morgan 5 years ago

Thank you for this. I'm glad to see someone in the healthcare profession speaking up. I personally like the softer spray and think they taste better. I feel like I get more medicine (when it is actually working properly and not clogged that is). However, I am one of those people that all that extra medicine I may be getting 'just doesn't work.' 5 or 6 puffs more often than not with little or no relief (by four puffs I give up on it now), and sometimes bronchial spasms and/or a coughing fit that actually makes the attack worse. If it does help, it is usually short lived--sometimes as short as 20 minutes. This is consistent with the three that I've tried--Proair (dangerously bad), Ventolin (really bad), Proventil (still bad but sometimes some relief).

Overall my asthma is worse and still declining since this switch. I have been told I'm not using it right, and to 'not use it so much'. I have had to learn to rely on a nebulizer for 'emergency' relief; a device I never needed before, and one that is being used in a situation that is far, far more common now. I also must use steroids--something else that wasn't necessary before. I sleep sitting up far too often, and sometimes sleep isn't possible. You can set a tune to my wheezing. People hear me coming.

For many these HFA inhalers work fine, but for some of us... Well... These things are killing people, and not in a nice way... 'Slowly drowning'as my physician put it. It's very sad, and I don't even have the energy to be angry anymore.

(For the record, I liked your jokes...)


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pharmacist 5 years ago from Whitinsville, MA Author

Hi Morgan,

Thanks for sharing. I hope, in addition to these "rescue" inhalers, you have a variety of other meds to help prevent these episodes. I know, sometimes even the best meds still don't work for everyone. Best wishes.


Heather 5 years ago

I now use the pro air and it relieves the tightness but the wheesing wakes me up and keeps me awake. I know I over use the damn thing but the wheezing is slowly driving me nuts

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