title: Alcohol-based pressurised metered-dose inhalers for use in asthma: a descriptive study.
abstract: BACKGROUND
  Chlorofluorocarbons (CFCs) have historically served as the propellants of choice in pressurised metered-dose asthma inhalers, but concern has been raised in recent decades regarding their damaging effect on the ozone layer. Among the alternative propellants being considered is alcohol, which can be used as a co-solvent in asthma inhalers. Healthcare professionals need to be aware of alcohol-containing inhalers, since certain populations may have religious and/or cultural concerns regarding the use of such preparations.
  
  
  OBJECTIVE
  To identify pressurised metered-dose asthma inhalers which contain alcohol-based propellants.
  
  
  METHODS
  We searched the British National Formulary to identify companies that manufacture asthma treatments and wrote to them to enquire about which of their products contained alcohol and if so in what percentage. These direct contacts were supplemented by searching medical databases and the Internet for additional information.
  
  
  RESULTS
  We identified 11 manufacturers of asthma inhalers, seven of which produced pressurised metered-dose inhalers; of these, six were willing to disclose the requested information, and information on the seventh product was obtained from an alternative valid source of information. Most CFC preparations contain alcohol, but CFC- and alcohol-free preparations do exist.
  
  
  CONCLUSIONS
  Clinicians need to be aware that the majority of CFC-free inhalers contain alcohol. Alcohol-free, and CFC- and alcohol-free, preparations are available for the delivery of both rescue and preventative treatment and these should be considered for use in those patients who may have concern about alcohol-based treatments.
authors.affiliation: Allergy & Respiratory Research Group, Division of Community Health Sciences: GP Section, University of Edinburgh, Scotland, UK.
authors.forename: Maryam
authors.initials: M
authors.lastname: Alrasbi
authors.forename: Aziz
authors.initials: A
authors.lastname: Sheikh
mesh_terms: D000335:Aerosol Propellants; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy; D030881:Disclosure; D004867:Equipment Design; D000431:Ethanol; D006801:Humans; D036501:Metered Dose Inhalers; D011356:Product Labeling; D006113:United Kingdom
chemical_list: D000335:Aerosol Propellants; D018927:Anti-Asthmatic Agents; D000431:Ethanol