Well this is exciting. I'd noticed lately that my inhaler was less effective than usual. It's a little light, but not so much that it's run out, so it's probably the fact that it expired last August. I'm guessing that in the case of inhalers, the propellant can slowly leach out, making expiration date more relevant than in many other drugs. This is not the first time that I've noticed the effectiveness decrease a year or two after the expiration date.
In case it wasn't clear, my asthma's quite mild, and I know my triggers well. I typically take one puff before exercising a few times a month (yeah, I don't exercise as much as I should), two puffs after the fact if I have to walk fast on very cold dry days, two puffs preventatively if I'm going into an environment with dogs or some other known allergen, or two puffs after the fact if I have an unexpected allergic reaction to something. This amounts to using one inhaler every few years, so I usually need to replace them due to reduced effectiveness after expiration rather than them actually running out.
When I had a checkup a few months ago, my NP mentioned in passing something about albuterol prescribing changing, something about brand names and generics, and I didn't think twice about it. I called up my online drug company today to get a new prescription, and the operator asked what the brand name was. I said "Armstrong," and she said "no, it's either..." and rattled off a string of brand names that I didn't see on my inhaler canister anywhere. I said "I heard there was some change in brands, and I got this one a few years ago so it must be before that change." And she demurred and implied that she couldn't get a prescription if I didn't have the brand name already. So I called my doctor's office and told the tech that I needed albuterol called in to my local physical pharmacy so she'll get the info from the doctor when the doctor has the time, and then I Wikipediaed.
Albuterol in the old form (like I apparently have) used CFCs as the propellant
. As of the end of 2008, by international treaty the FDA banned all CFC-based inhalers. A number of companies (the ones rattled off to me by the operator) have developed proprietary non-CFC propelled inhalers, with the result that no generic albuterol inhalers currently exist, and with the added bonus of an average increase in cost of $20 per inhaler - a benefit which I expect will be passed on to me, the consumer, when I actually get the prescription.
So now I'm wondering which of the brands my doctor will prescribe me, if there are additional side effects I have to worry about, if I'll have to go to the doc in person to discuss this, and if it'll cost a lot more. Anyone here use an albuterol inhaler and notice any difference around 2008-2009 when things changed?