CFC-free inhalers: India set to make the switch !!

With the world celebrating the 'International Ozone Day' on Sunday (September 16) & after successfully phasing out ozone-depleting chlorofluorocarbons (CFC) from air-conditioners, refrigerators and hairsprays, India is all set to phase out the CFC containing metered dose inhalers (MDI) used by asthma and COPD patients & replace them with ozone-friendly CFC-free versions.

CFCs are used as
propellants in asthma inhalers which create the fine spray that is inhaled. CFCs are seen to contribute to the depletion of the ozone layer, leading to higher ultra violet radiation & consequent global warming.

When the world agreed on the
Montreal Protocol , CFCs in asthma inhalers were the last ones left for phase-out, as these were considered an “essential drug”. All 160 signatory countries had agreed to 2010 as the deadline for a 100 per cent CFC-free world.

For India, with an estimated 22-25 million asthma and bronchitis patients dependent on inhalers, the change to non-CFC alternatives is perceivably expensive and difficult.
The new CFC free MDIs use HFA (Hydro Fluoro Alkane) as the propellant & will be 20% more expensive than the conventional ones.

‘We are in the process of changing the technology, equipment and facility to roll out the new technology in inhalers. This has required a sizeable investment of nearly Rs 100 crore. The inhalers will be commercially available in the market, in phases, over the next few months,’ says Amar Lulla, joint MD, Cipla, which is the market leader in asthma inhalers. Drug major Ranbaxy has already introduced a range of inhalers using HFA technology.

The FDA has found that HFA inhalers are safe and effective, and patients should not find any significant differences from their CFC inhalers. However, some patients might find that the new inhalers have a slightly different taste or feel. The mist is less forceful & warmer. Also the new inhalers may need to be cleaned & cared for differently. Since all HFA inhalers do not contain the same inactive ingredients, one may want to try out more than one kind in advance of the deadline to find the most suitable one.


  1. Anonymous says

    The new inhalers do not work for me and thousands of others. Please sign the following petition to let the FDA and EPA know how you feel about taking away our right to breathe.

    Seeji says

    @ anonymous

    We understand your concerns. I myself was involved in a multicentric study to compare between HFA & CFC inhalers for one ICS (Inhaled corticosteroid). Though, I could not compare the efficacy with in my patients because of the double-blind and multi centric nature of the trial, the final report came as non-inferiority. That translates to no significant difference between the two.
    But as observed in the clinical practice, some patients find it better with the CFC inhalers and some have no problem with the HFA shift.
    In my opinion, keeping in mind of environmental damage, there should be incraesed advocacy to use HFA inhalers. But CFC inhalers should also be available for a small fraction of patients who feel better with CFC.

    jhilaam says

    @ anonymous

    Thanx for writing in & letting us know of your problem.The FDA-proposed phase out will only take place when the new devices will be available to meet the emergency need of majority of people.As mentioned in the post some patients will find it difficult using the new device.I suggest you try out more than one type of the HFA inhalers & find out the most suitable one for you.Ask your phusician to help you make the proper choice.One type may not work well for you, while some other might.It may take some time before you get used to with the new device.

    jhilaam says

    @ Seeji

    Thanx for sharing the noninferiority results...Hope it be only a matter of time before patients who are finding it difficult with HFA devices get used to with them.

    Anonymous says

    For more information and to help us win this fight so that all pulmonary patients have the right to breathe: