Patients with asthma or chronic obstructive pulmonary disease (COPD) may see delays in albuterol inhaler availability from their pharmacy due to the COVID-19 outbreak. The inhalers are being used in emergency rooms to treat respiratory distress from coronavirus infection. This increased demand is resulting in strain on manufacturers to keep up with production. While albuterol is also available through a nebulizer, emergency room physicians are concerned that using nebulizers in busy emergency rooms could result in more virus particles being introduced into the surrounding air. So far, we don't have any data to prove that nebulizer use does increase airborne virus, but providers are reaching for the inhalers in the ER out of caution.

Fortunately, manufacturers have said they increased production of inhalers to prevent a long term shortage. According to the American Society of Health-System Pharmacists (ASHP), current inhalers affected include the following:

ProAir HFA (Teva)

Ventolin HFA (GSK)

Generic albuterol from Teva, Prasco and Par Pharmaceuticals

The following inhalers are not facing short supply:

Proventil HFA (Merck)

ProAir Respiclick (Teva)

ProAir Digihaler (Teva)

The best strategy to deal with this situation is to keep your asthma in great control so you'll be less likely to need to use albuterol in the first place. While we know that people with asthma are not at increased risk of becoming infected with COVID-19, we do know that people with uncontrolled asthma do poorly when infected with the coronavirus. Dr. Steven is now offering both in-office and telemedicine visits to address your concerns if you're not sure if you need to be doing anything differently to ensure maximum asthma control.

What should I do if my pharmacy can't fill my inhaler prescription?

• Call our office. There are other medications available that may work for you.
• You can try calling other pharmacies in your area to see if they have your prescription in stock. Websites like GoodRx.com can help you find pharmacies near you.
• If you have an expired inhaler, the medication in it is still partially effective and can be used if needed, as long as the dose counter isn't at zero.
• Avoid your asthma triggers to prevent flare-ups.
• Make sure you aren't overusing your albuterol inhaler. One canister should last several months, and you should not need to use albuterol more than twice per week. If you need albuterol more frequently, your asthma may not be well controlled. Call our office to schedule an appointment to evaluate your asthma and get you under better control.

Some patients also use nebulizers at home for their albuterol medication. There is no need to make any changes to your routine if you are feeling normal. If you have been diagnosed with COVID-19 or feel sick, the American College of Allergy, Asthma & Immunology (ACAAI) recommends using your nebulizer away from other people in your home. Places like your porch, patio, or even the garage are ideal since the air does not circulate into your home.

As with everything else during the pandemic, it is important not to panic. Check how much albuterol you have remaining, and follow the steps above if you need a refill. If you have difficulty getting your inhaler prescription or feel your asthma may not be well controlled, don't hesitate to contact our office. We remain open to help our patients stay in good health during the coronavirus emergency.