Q. My pharmacy switched me from the asthma inhaler Ventolin to a generic albuterol. It doesn’t work nearly as well. I have to prime the inhaler several times before the medicine comes out correctly and even then it doesn’t open my airways as much.

The pharmacy says the generic is the same as Ventolin, just from a different company. How could that be true?

A. The FDA maintains that all generic drugs on the market are identical to their brand name counterparts, but we have discovered that is not always true. Generic drugs may have different inactive ingredients and release their active agent differently.

We have heard from others who believe that some generic albuterol inhalers are not as effective as the branded asthma medicine. For more information about asthma and our Top 10 Tips for Taking Generic Drugs, we offer our book, Top Screwups Doctors Make and How to Avoid Them.

Mike had this to say about his experience with albuterol: I’m 72 years old and I have had asthma since I was 18 years old. At first, in the early days, I was on ephedrine. Then in the 1960’s the drug companies came out with Ventolin and later Albuterol.

“All was well until about 2 years ago, when I suddenly had a violent asthma attack which sent me to the ER because the Albuterol didn’t work! I was pumped full of steroids and stabilized but it was SCARY! I was also told I had mild COPD, probably caused from smoking even though I gave up smoking 30 years ago. End result of the ER visit was I was put on Symbicort (2 times a day) as well as Albuterol for emergency attacks.

“Determined to try and get out of the clutches of the medical profession and to stop being a cash cow for the pharma companies, I did a LOT of internet research and came upon a method called The Buteyko System.

“Dr. Buteyko was a Russian doctor who as a young MD in the 1950’s, was assigned to watch people die in a Russian hospital and take notes. He did AND he started to notice something about their breathing patterns. To cut a long story short, Buteyko spent his life working on breathing as related to Asthma. Much of his work never saw the light of day outside of Russia because of the cold war, but when the Berlin Wall came down in the 1980’s, the results of his research and work started to filter out. Again, I will try and cut this short:

“I took the Buteyko Course for 2 days in California. I now no longer need the albuterol. 7 months without use. I take 1 dose of the lowest amount of Symbicort every 2 days. I have no problem walking 4 miles a day. No drugs are used in the Buteyko Method. It’s too involved to get into but if you or your children suffer from asthma OR mild COPD, get a book called, “CLOSE YOUR MOUTH”, by Patrick McKeown who is a Buteyko practitioner. He lives in Ireland and has a clinic there but he travels around Europe and sometimes the USA. He was a severe (very severe) asthmatic prior to meeting Dr. Buteyko and taking the course.

“If you need more proof, go onto YOUTUBE and put in Buteyko. About 50 videos come up showing the results from all over the world but hardly any from the USA. There are 1 or 2 videos on YOUTUBE of doctors who say the system is rubbish. Really! Well, I’m living proof and there are hundreds of others who are living proof (mainly in Europe and Australia and the UK) who can confirm that the Buteyko System WORKS!”

To listen to a radio show in which we discussed the Buteyko approach, check our show #826 on Asthma

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  1. Isabel
    Cullman, AL

    My daughter’s insurance will only pay for the generic for albuterol. She says that it “doesn’t work as well” as the name brand. Her doctor suggested perhaps the mechanism was not working as well to get the medicine where it needs to be. So far, her doctor will just not take us seriously.

  2. A.P.

    There is NO generic albuterol inhaler on the market in 2013. There are four brand-name quick-relief inhalers, three albuterol and one levalbuterol, but NO GENERIC inhaler. Inhalers have a different propellant, thus there are new patient instructions – we are years into this switch of propellants. Please consult your allergist.

  3. J.V.I.

    As a student at the University of the West Indies, Mona, Jamaica, in the 1980’s, I suffered badly from allergic rhiniitis, and it’s attendant problems of sinusiitis, tonsyliitis, bronchial asthma, and respiratory infections every month. Also, I had asthmatic attacks frequently.
    When I was switched from a Ventolin Inhaler to Salbuterol, I noticed that, I didn’t receive the same degree of relief, but, thought I was imagining things, until a conversation with a fellow sufferer elicited the same information.
    Eventually, after three years of injections in a programme to desensitise me to the numerous allergens which affected me, I took the advise of the Allergist, and left Kingston.

  4. Donnie

    A lot of people have discovered that the newer type of inhalers that contain ethanol do not work. And those of us who are allergic to corn have severe reactions to the ethanol in them, and are even worse off. The safer CFC type inhalers that were used for many years was banned, and the inhalers now use ethanol. They are pretty worthless as rescue inhalers.

  5. LL

    I took your article to my pharmacist & she said that there were still no generic albuterol inhalers being made. She said that since the FDA required the inhalers to be more friendly to the environment, all the generics were phased out. She said there were 3 brands, Ventolin HFA, Proair HFA, and Proventil HFA. Can you find out if this is true? The brand inhalers are expensive & I would prefer to have a generic. Thank you

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