Is there still some powder left in that keg?

February 10, 2025 5:27 PM

My steroid inhaler indicator says the container is empty. But it does not feel that way.

I use a Pulmicort flexhaler on a daily basis in the winter to forestall bronchitis. It has worked well, however, because America, now my insurance no longer wants to cover it. The indicator dial on the flexhaler is at zero now, but I can definitely hear a substantial amount of powder (or so it sounds) when I shake it. When I inhale, I still feel like I am getting something. Basically it seems quite far from empty. Like maybe it has dozens of doses left. So can I just assume whatever sounds like powder in there is, in fact, the medicine, and keep using it until it runs out? Does anyone know how many other doses there are likely to be after the dosage indicator reaches zero? YANAD/YANMD as always.

posted by virve to Health & Fitness (6 answers total)

Best answer: From my experience with inhalers, yes, they will totally contain more, but the zero mark is probably the point at which they can no longer guarantee that it delivers the appropriate dosage from the mechanism. Also, keep in mind the powder is largely propellant, so the inhaler being not-entirely-empty might not guarantee anything about the medicine content. Personally, I find it always tends to get weaker after the zero point.

So if you don't particularly care about getting the dose right (e.g. if using an asthma inhaler for wheezing in non-emergency situations) it's totally fine. But for something where you're expected to use a specific dose on a regular basis its probably not a good idea.
posted by etealuear_crushue at 6:34 PM on February 10 [5 favorites]

Best answer: I use inhalers.

My ventolin in Canada is not metered
My other inhalers are.
I expect there to be a safety margin, If there is a hundred doses and counts to zero, There's probably a bit more.
How much ? I don't know.
It would not bother me to take dose 101.
Dose 120? No
You cant tell how much is propellant and how much is medication.
If I was forced to. then take it, but only as a last resort
posted by yyz at 6:47 PM on February 10 [2 favorites]

I use that exact same inhaler and I usually let it go a bit longer past the zero mark for the same reasons you give. Maybe an extra week or so? Never had an issue.

Also when I first started using it I tried out a half-dose (one puff in the morning and one in the afternoon) and honestly that worked perfectly fine so I’ve been doing that ever since. Easy way to make the inhaler last twice as long.
posted by Aznable at 6:52 PM on February 10

3 suggestions: 1) Ask your doctor to pursue a prior authorization for the Pulmicort through your insurance. This has worked for some depending on the insurance company.

2) My nephew recently had to change inhalers because the company stopped producing the one he'd been on. Being ASD, this was a challenging issue. He switched to the Advair Diskus and has mastered the change. You can talk to your doctor about which alternative would provide the best substitute, but you should research your insurance's formulary to see which ones they support so you know they are prescribing one that will be covered.

3) Because US health coverage sucks, you can ask for assistance from the manufacturer of your medication. If you are low income they may have a very low cost program, or if you have insurance they may have a program that underwrites part of the cost at the pharmacy. I get my inhaler through such a program and it only costs me $25/month (which is still outrageous for a life-saving medication, but better than the $200+ it would cost me without). It appears AstraZeneca has a program: Astrazeneca patient affordability
posted by drossdragon at 8:54 AM on February 11

Response by poster: Thank you to everyone who answered my actual question about the mechanics of my flexhaler. I didn't know about propellant (had to look it up), and had assumed that everything that I was hearing there that sounded like "powder" was the active medication. This is helpful to know.
posted by virve at 3:07 PM on February 11

FYI unless you found something that said that your model flexhaler specifically uses propellant, I don't think it does. I had a disc inhaler that delivered powder, and it had stabilisers but not propellant. When I primed it, it cracked open a small bubble that contained the powder. It's not an aerosol squirting out a nozzle, it's a powder you're inhaling. It doesn't need propellant, it's not under pressure.

I could be wrong, it's been a long time since I used powder inhalers.
posted by Gorgik at 4:37 PM on February 11