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Each HFA inhaler has a different priming mechanism and cleaning and drying instructions. So, users should carefully read the instructions before using the inhaler. And HFA inhalers may cost more, because there's no generic HFA inhaler available yet, Chowdhury said.

Three HFA-propelled albuterol inhalers have been approved by the FDA: Proair HFA Inhalation Aerosol; Proventil HFA Inhalation Aerosol; and Ventolin HFA Inhalation Aerosol. Also, an HFA-propelled inhaler containing levalbuterol, a medicine similar to albuterol, is available as Xopenex HFA Inhalation Aerosol, the agency said.

Dr. Ira Finegold, chief of the Division of Allergy and Clinical Immunology at St. Luke's-Roosevelt Hospital Center in New York City, doesn't see much difference in the effectiveness of the two types of inhalers. "The end result -- if you need it, does it open up your lungs? Yes, it does," he said.

However, the changeover will involve some patient education, he said. "The old medication, CFC albuterol, was really a very nice product, because the propellant got in your body and came out of your body -- it wasn't absorbed. And remarkably, it is a cleaning agent, so the device was self-cleaning."

The new HFA propellant is safe in the body but can clog the inhaler, Feingold said. "So, after use, these inhalers need to be rinsed out or they are not going to work correctly," he said.

"In addition," Feingold added, "each of the four new inhalers on the market is different in the number of times you have to prime it. There is also a little difference in feel and taste."

The discontinuation of CFC-propelled inhalers is the result of the U.S. Clean Air Act and an international treaty known as the Montreal Protocol on Substances That Deplete the Ozone Layer.

Under provisions of this treaty, the United States agreed to stop the production and importation of substances that damage the ozone la
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