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FDA Announces Removal of Several Asthma Drugs Due to CFC-propeller

The FDA announced the staged removal of some familiar MDI aerosol asthma/COPD products propelled by chlorofluorocarbons (CFCs) (shown in the figure below).



The affected products, manufacturers and their phase out schedule include:

- Tilade Inhaler (nedocromil; King Pharmaceuticals) -- June 14, 2010
- Alupent Inhalation Aerosol (metaproterenol; Boehringer Ingelheim Pharmaceuticals) -- June 14, 2010
- Azmacort Inhalation Aerosol (triamcinolone; Abbott Laboratories) -- Dec. 31, 2010
- Intal Inhaler (cromolyn; King Pharmaceuticals) -- Dec. 31, 2010
- Aerobid Inhaler System (flunisolide; Forest Laboratories) – June 30, 2011
- Combivent Inhalation Aerosol (albuterol and ipratropium in combination; Boehringer Ingelheim Pharmaceuticals) – Dec. 31, 2013
- Maxair Autohaler (pirbuterol; Graceway Pharmaceuticals) – Dec. 31, 2013

After those dates, these medications will not be sold or distributed in the United States.

Combivent is especially popular with COPD patietns and they may experience additional costs from co-pays on individual inhalers as opposed to the combination. Maxair is breath activated inhaler and the patients who curently use it will need to learn how to use the "standard" push-to-activate MDIs.

As you can see from the chart above, both Combivent and Maxiair Autohaler will be available until the end of year 2013.

Albuterol CFC-MDI was discontinued in December 2008. Epinephrine CFC-propelled inhaler, currently available over-the-counter (not recommended), will be phased out by December 2011.

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