Complications of HFA Inhalers

Prior 2009, most inhalers in the United States used CFC, or chlorofluorcarbons, as a propellant. The sale of CFC inhalers in the United States was halted on December 31, 2008. New inhalers replaced CFC with HFA, or hydrofluoroalkane. HFA is an environmentally friendly alternative propellant for use in inhalers and has been safely used and FDA approved since 1998. HFA inhalers have a different set of complications as compared with their CFC-based predecessors.

Medicine Accumulates in the Actuator

• HFA inhalers require cleaning to prevent the medicine from accumulating in the actuator and blocking the spray's flow. If inhalers are not cleaned regularly and correctly, the inhaler may not spray medication. Clean the inhaler at least once per week by removing the canister from the actuator and taking the mouthpiece cap off. Run warm water through the actuator's top for about 30 seconds; run warm water through the actuator's mouthpiece for another 30 seconds. Shake excess water off of the device and examine the mouthpiece to ensure all buildup is gone. If there is any accumulation remaining, repeat the process. Otherwise, allow the actuator to air dry overnight before replacing the canister. Each type of HFA inhaler comes with cleaning instructions specific to the brand.

The Spray Feels Different

• The force of the medication's spray feels softer, more like a fine mist, from an HFA inhaler than from a CFC inhaler. However, the force of the inhaler's spray is not what delivers the medication to the lungs. According to the FDA, taking a deep breath with each puff of the inhaler transports the medication to lungs as effectively as the more powerful spray from a CFC inhaler.

HFA Inhalers Are More Expensive

• According to the Environmental Protection Agency (EPA), HFA inhalers are more expensive than CFC inhalers due to the lack of generics. Many HFA inhalers manufacturers have, however, begun patient assistant programs to help offset the increase in out of pocket expenses. Applicants to patient assistant programs must meet the manufacturer's requirements. Requirements commonly include lack of health insurance benefits for prescription drugs, United States residency and income level requirements. Some pharmacies and physicians may also provide coupons for discounts on HFA inhalers.

Adverse Effects

• Adverse effects associated with HFA inhalers include dizziness, nausea, vomiting, headache, sore throat, inflammation of the upper respiratory system, viral infections of the respiratory system, increased nervousness, rapid heartbeat, cough and increased pain. These are side effects of the medication being delivered by the inhaler.