As of January 1, millions of Americans may find out the hard way their inhalers are being changed.
The medication inside the devices is staying the same. But the way the drug is propelled into the body will be different.
Lung experts worry not enough people are prepared mentally, physically or financially for the switch.
Keron Woods has asthma and so does her daughter autumn. Inhalers are their lifeline. When asthma flares up, choking their airways, a puff and a deep breath of albuterol brings relief.
"It's a lifesaver I keep mine with me all the time because you never know what can happen," said Woods.
But by January 1, 2009 the inhalers millions of patients have come to rely on will no longer be available.
The medication will stay the same but the propellant that pushes albuterol out of the can is changing.
Ozone damaging chlorofluorocarbons or CFCs are being replaced with the more environmentally friendly alternative hydrofluoroalkanes or HFAs.
"This is a huge transition that I don't think the government properly prepared for," said Maureen Damitz, Respiratory Health Association of Metropolitan Chicago.
Damitz stands behind the new inhalers but worries the federally mandated switch isn't getting enough publicity.
"By changing the propellant it has changed the way that our medication feels, the way it tastes and the way it comes out," said Damitz.
Some patients are already using them but for those who will be making the switch it might be awkward.
Albuterol with the HFA propellant comes out slower and may feel warmer. According to pulmonologist Edward Naureckas, that's a good thing.
"Theoretically the new inhalers, because they took advantage of the change-over to redesign the way the medicine is propelling may have better delivery to the smaller airways and may actually bet better broncodialation," said Dr. Edward Naureckas, Pulmonologist, University of Chicago Medical Center.
But without the familiar cues of the old inhalers many patients might believe the new ones aren't working.
There are other differences. The new inhalers must be cleaned frequently because they can clog also. They need to be pumped four times before use. When someone is gasping for air, panicked for relief and unprepared for all the changes, the situation could become serious.
"We are going to have patients who don't know how to use their equipment, don't know how to save their own life," said Damitz.
At the University of Chicago Medical Center, patient educators are doing their best to raise awareness.
The biggest shock may be the cost. The price tag could be up to four times more because there are no generic versions. For instance, instead of $12, one inhaler could cost up to $45 or higher.
Chronic obstructive pulmonary disease patient Alice Burgess is furious.
"I don't know how I'm going to handle it but you know you have to breathe," said Burgess.
Doctors tell ABC7 a lot of people have been stockpiling the CFC inhalers in preparation for the ban that goes in effect at the end of this year.
But at this point, many pharmacies have already made the switch to the HFA varieties.
For more information:
Respiratory Health Association of Metropolitan Chicago
1440 W. Washington Blvd.
Chicago Asthma Consortium
4541 N. Ravenswood Ave.
Dr. Edward T. Naureckas
Dir. Pulmonary Function Laboratory
University of Chicago Medical Center
5758 S. Maryland Ave.
Chicago, Il. 60637
Allergy Asthma Network Mothers of Asthmatics
800-315-3506 Carol Jones, Nurse Educator
Asthma and Allergy Foundation