How the Albuterol Shortage Will Impact Your Chronic Lung Disease

You may have recently heard, via the news (CNN & ABC News), about a concern over a shortage or potential future shortage of liquid albuterol. This medicine is a common respiratory quick-relief (rescue) treatment. It is available for multiple chronic lung diseases including asthma, COPD, COVID-19, respiratory syncytial virus (RSV), pneumonia and frequently used across all populations and settings.

Albuterol is one of several bronchodilators that relaxes the smooth muscles of the airways to help open the airways in response to symptoms such as cough, wheeze, shortness of breath or tightness. It is available in inhaled aerosols or powder to treat these symptoms.

The albuterol sulfate inhalation solutions have been on the Food and Drug Administration (FDA) Medication Shortage list since October 2022. This is the liquid format used for continuous nebulizer treatments that are common in healthcare systems, emergency departments and hospitals.   Albuterol sulfate HFA Inhalation aerosol for individual metered dose inhalers and nebulizer treatments at home do not seem to be impacted by the shortage so far, but community response could impact this status due to overreaction or personal concern regarding accessibility.

Why is this happening?

A primary major U.S. manufacturer (Akron Operating Company, LLC) has shut down production in three factories as of February 2023, therefore reducing the supply and distribution sources provided to hospitals. There remains one U.S. manufacturer (Nephron Pharmaceuticals) that is experiencing an increase in demand. This is a concern now as the need for albuterol may increase with the circulating viruses and an early allergy season.

Hospitals are monitoring and maintaining their supplies to meet the needs of patients, including keeping larger stock and compounding or adjusting protocols and varying suppliers. Alternative medicine such as levalbuterol and others may be options as well.  New manufacturers will start albuterol production and the FDA may adjust expiration dates to existing supplies or provide new supply lines and global alternatives.

The American Lung Association will continue to monitor the situation and advocate for changes to improve and manage community needs.

Guidance for Patients and Caregivers: 

• Stay calm and monitor your medicine supply.
• It is important to continue taking your medicines as directed for asthma and other lung diseases. 
• Proper technique when using inhaled medicines is important.  Learn the best way to use your medicine device to obtain the most effective treatments for nebulizers or inhalers. New “How to” videos and handouts are available for multiple devices.  
• Do not ration your medicines. If you are running low on a prescription speak with your healthcare provider about options so you can take your medication as prescribed.
• Alternative bronchodilators do exist. Speak with your doctor to determine if switching medicines helps with better availability and/or lower costs.   Consider devices such as metered dose inhalers or dry powder inhalers. A valved holding chamber/ spacer is always recommended for use with metered dose inhalers.  Dosages are different in and among different brands so do not switch without discussing with your healthcare provider.
• If your insurance allows, secure a 90-day supply of prescription medications. Consider mail order pharmacy options.
• Contact the Lung Association’s Helpline & Tobacco Quitline (1-800-LUNGUSA) to talk with an expert.
• Learn more about Asthma and other lung diseases.