Difference between albuterol manufacturers, defective inhaler, or other?
January 9, 2018 1:34 PM   Subscribe

I have two albuterol inhalers. They seem to work differently. Please help me figure out what the issue is.

I have an albuterol inhaler that lives in my bathroom (ProAir HFA), and one that I carry with me in my tote bag (Ventolin HFA). They're the same dosage, and I use each with a spacer, although the plastic housing of the Ventolin inhaler doesn't fit as well in the spacer. (There's no good reason why one manufacturer's inhaler from the pharmacy one time and got the other the next; that happens pretty often with my prescriptions.)

The ProAir gives me the shakes like crazy and leaves more of an aftertaste -- both negatives, obviously! But, I also feel like it might work better.

1) Is it possible that the ProAir inhaler's side effects are tricking me into thinking it's the more effective of the two? 2) What's the possibility that the two inhalers made by different manufacturers, but with the same drug and the same dosage, have a significantly different effectiveness? Are they different formulations? 3) Might I just have a defective Ventolin inhaler?

Basically, is it more likely that they're equally effective, but one just has less noticeable side effects and therefore feels less effective?

I thank you, and my flu-ravaged lungs thank you. Personal experience with these inhalers most welcome.
posted by mudpuppie to Health & Fitness (11 answers total) 2 users marked this as a favorite
I think it has to do with a difference of "spray force." Check out the abstract on this paper, which explains it a bit.

"The ProAir(®) HFA delivers a warmer, lower-impact, and longer-lasting plume compared with Ventolin(®) HFA, which may provide a more consistent, comfortable experience for patients using a pMDI. ProAir(®) HFA produces higher fine particle dose than Ventolin(®) HFA."
posted by LKWorking at 1:48 PM on January 9, 2018 [2 favorites]

I can confirm you and LKWorking, ProAir works better for me but also makes me speedier and does seem to be related to the type of spray. Nothing is as good as the CFC inhalers and I am still ticked off about that BS won't actually help anything restriction.
posted by I'm Not Even Supposed To Be Here Today! at 1:51 PM on January 9, 2018 [2 favorites]

For me they act the same.

First thing I'd check is that the inhaler is clear of blockages, that both were primed correctly if one is new, that the counter is working with the number of dosages left and that neither are expired.
posted by AlexiaSky at 1:52 PM on January 9, 2018 [1 favorite]

No experience with Ventolin, but I know that in my experience the ProAir HFA inhaler works better than the ProAir RespiClick, which I attribute to the fine spray making it easier for my sad lungs to suck all the medicine down where it can do some good.
posted by oblique red at 2:46 PM on January 9, 2018

For me the ProAir works better than the Ventolin, but I don't get the shakes more with one than the other. I get a bit of dizziness with both. Whatever the reason for the difference is, I believe that it is real. My doctor had been writing my prescription in a way that allowed for either (I believe she was prescribing for albuterol) so that the pharmacy could give me whichever was cheaper under my insurance at any given time (taking into account both the cost of the medicine and the insurance reimbursement -- the former varies month-to-month, and the latter year-to-year). I asked her to please prescribe the ProAir, even though it means I sometimes pay more for it, because I feel that it is more effective.
posted by OrangeDisk at 2:56 PM on January 9, 2018

The ProAir gives me crazy shakes and the Ventolin doesn't; I also feel like the ProAir works better but I don't know if that's a real thing. I also request ProAir specifically, even though the side effects are unpleasant.
posted by goodbyewaffles at 3:16 PM on January 9, 2018

I think they probably have a different spray force. A few years ago I returned two Albuterol-based inhalers (I can't remember the name brand) after they changed the packaging, and I can say they had *zero* spray force. The pharmacists were flabbergasted and asked if I'd emptied them both, and I had not. They were either defective or completely dependent on me sucking the medication out of them. I didn't respond at all to them.

In contrast, my old Albuterol (Ventolin) worked like a charm. Every time. I'm not sure what was going on with those sad little canisters masquerading as effective medication. I always suspected it was a manufacturing defect (I'm sure that happens), but I was so frustrated and wheezy that I insisted on something else, which ended up being the fourth class of Albuerol, Xopenex. Reading this thread, I wonder if the propellant was different.

Xopenex has a wimpy spray, but it seems to work, and I usually just double up to get the same effectiveness as the original Ventolin that I used in the first place.

I wonder if the Ventolin was a CFC inhaler and Xopenex an HFA inhaler? I have no idea, but I miss my old one (presumably with the CFC propellant) and Kaiser won't prescribe it anymore, which sucks (ha! no pun intended) and I don't know why.
posted by onecircleaday at 4:28 PM on January 9, 2018 [2 favorites]

I have both and I think that it’s because the ProAir actually gets the medicine where it’s supposed to go! For me anyway, the Ventolin seems to just hit the back of my tongue and stay there when I inhale. The ProAir stays... airborne?... in my mouth so when I inhale it actually gets breathed in.
posted by rabbitrabbit at 4:50 PM on January 9, 2018 [1 favorite]

Thanks everyone! The verdict is in: I'm not crazy.
posted by mudpuppie at 5:34 PM on January 9, 2018 [2 favorites]

For me xoponex works about as well with much less shaking and tachycardia. Reentrant tachycardia sucks. Hope you less muddy-lunged soon.
posted by Dashy at 7:12 PM on January 9, 2018

I frequently get the same two inhalers, and while the ProAir doesn't give me the shakes, I definitely feel like I get more of the medicine when I administer it. Which means I actually prefer that one because it feels like it's easier to use and more effective. The Ventolin one always feels like I have to inhale twice as hard to get anything, which, as you know, can be pretty difficult for someone having an asthma attack.

If I recall correctly, this didn't become a problem until they changed their canisters for environmental reasons a few years ago. I think some drug companies figured out how to still deliver the medicine efficiently and some still haven't worked out the bugs.
posted by katyggls at 3:08 AM on January 10, 2018

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