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U.S. Department
of Health and
Human Services
FDA ADvises PAtients to switch to hFA-ProPelleD Albuterol inhAlers now CFC-propel ed inhalers no longer available as of Dec. 31, 2008
The U.S. Food and Drug Administration today issued a public health advisory to alert patients, caregivers and healthcare professionals to switch to hydrofluoroalkane (HFA)-propelled albuterol inhalers because chlorofluorocarbon (CFC)-propelled inhalers will not be available in the United States after Dec. 31, 2008.
CFC-propelled albuterol inhalers are being phased out because they are harmful to the environment by contributing to depletion of the ozone layer above the Earth’s surface.
Three HFA-propelled albuterol inhalers have been approved by the FDA: ProAir HFA Inhalation Aerosol, Proventil HFA Inhalation Aerosol, and Ventolin HFA Inhalation Aerosol. In addition, an HFA-propelled inhaler containing levalbuterol, a medicine similar to albuterol, is available as Xopenex HFA Inhalation Aerosol.
“Concern about the environment stimulated the need to phase out CFCs,” said Janet Woodcock, MD, director of the FDA’s Center for Drug Evaluation and Research. “The FDA wants to emphasize that HFA-propelled albuterol inhalers are safe and effective replacements for CFC-propelled albuterol inhalers.” Albuterol inhalers are used to treat bronchospasm (wheezing) in patients with asthma and chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. Patients use albuterol inhalers to deliver medicine directly into the lungs.
The FDA is urging patients to talk with their healthcare professionals now about switching to HFA- propelled albuterol inhalers. These products are safe and effective replacements for CFC-propelled albuterol inhalers.
Manufacturers have been increasing production of HFA albuterol inhalers, so an adequate supply is HFA-propelled albuterol inhalers may taste and feel different than the CFC-propelled albuterol inhalers. The spray of an HFA-propelled albuterol inhaler may feel softer than that of a CFC-propelled albuterol inhaler. Patients must also prime and clean HFA-propelled albuterol inhalers. Doing so prevents buildup of the drug in the inhalation device, and buildup can block the medicine from reaching the lungs. Each HFA-propelled albuterol inhaler has different priming, cleaning, and drying instructions, and patients should read and understand the instructions first before using the inhaler.
The phaseout of CFC-propelled inhalers is the result of the Clean Air Act and an international environmental treaty, the Montreal Protocol on Substances that Deplete the Ozone Layer. Under this treaty, the United States has agreed to phase out production and importation of ozone depleting substances including CFCs. No CFC-propelled albuterol inhalers may be produced, marketed or sold in the United States after Dec. 31, 2008.
For more information: http://www.fda.gov/cder/mdi/albuterol.htm

Source: http://www.dan-wong.com/introweb7174/2nd%20VER.%20PDF%20PG%2023..pdf

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Manual therapies for migraine: a systematic reviewAleksander Chaibi • Peter J. Tuchin •Michael Bjørn RussellReceived: 4 November 2010 / Accepted: 14 January 2011 / Published online: 5 February 2011Ó The Author(s) 2011. This article is published with open access at Springerlink.comMigraine occurs in about 15% of the generaldue to side effects, or contraindications due to co-morbiditypopu

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