Aerating machine with mask for liquid albuterol

March 7, 2023

People with asthma and many hospitals are experiencing a shortage of albuterol medication.

A major U.S. manufacturer of liquid albuterol, Akorn Pharmaceuticals, closed three of its plants in February 2023 and is also ending its U.S. operations. This leaves just one U.S. manufacturer of liquid albuterol: Nephron Pharmaceuticals. Media reports say Nephron is already experiencing a backlog of orders.

Liquid albuterol is used in nebulizers to treat asthma. The nebulizer converts the liquid into a fine mist that is then inhaled. Many people with asthma and hospitals rely on liquid albuterol for quick-relief breathing treatments.

Albuterol has been on the Food and Drug Administration (FDA) medication shortage list since October 2022. In addition to asthma, albuterol has been used to treat COVID-19 and respiratory syncytial virus (RSV). The United States experienced a surge of RSV cases in 2022.

The shortage does not appear to be impacting bronchodilator inhalers – at least not yet. Health officials warn that If there is a rush to hoard albuterol inhalers, or if more hospitals opt to use inhalers instead of nebulizers, this could cause an inhaler shortage. Bronchodilator inhalers contain aerosol and powder forms of albuterol to treat asthma attacks.

Albuterol relaxes and opens the airways to treat asthma symptoms, such as coughing, wheezing, chest tightness and shortness of breath.

Allergy & Asthma Network will continue to monitor the situation.

In 2020, certain areas of the United States experienced a shortage of albuterol quick-relief inhalers. The shortage occurred due to supply chain issues and increased use of albuterol inhalers in hospitals to treat COVID-19 patients in respiratory distress. Since then, drug manufacturers have resupplied pharmacies with albuterol inhalers.

People with asthma should note that ProAir HFA was discontinued by Teva in October 2022. Contact your doctor for alternatives. Generic versions are available.

What to do if you’re unable to get your albuterol inhaler?

  • Contact your primary care doctor or asthma specialist – other inhaler options including generics are available, according to the American College of Allergy, Asthma & Immunology (ACAAI).
  • Visit online pharmacies for availability of albuterol medications as well as potential discounts. GoodRx, Singlecare, Medicine Assistance Tool, Amazon Pharmacy, CostPlus Drug Company and/or Needymeds may be able to fill your prescription.
  • Check your inhaler to see if it still contains medicine in it. If necessary, you can use a recently expired albuterol inhaler as it probably is still at least partially effective, ACAAI says.
  • Follow your Asthma Action Plan and avoid your asthma triggers to prevent flare-ups.
  • Do not overuse your albuterol inhaler, ACAAI advises. One canister should last for months. If you’re using a quick-relief albuterol inhaler more than twice a week to relieve asthma symptoms, that’s a sign your asthma may not be well controlled and you should see an asthma specialist.

For additional help and information, please visit: What can I do if I can’t afford my asthma medication?

Allergy & Asthma Network advocates for pharmacy benefit managers and payers to expand formularies to ensure all branded and generic albuterol inhalers are accessible for patients.

The Network also encourages people with asthma to ensure they always have albuterol inhalers on hand. It is vital that people with asthma continue to take their medications as prescribed, in addition to following CDC-recommended prevention steps such as getting vaccinated.

Reviewed by:
Purvi Parikh, MD, FACAAI is an adult and pediatric allergist and immunologist at Allergy and Asthma Associates of Murray Hill in New York City. She is on faculty as Clinical Assistant Professor in both departments of Medicine and Pediatrics at New York University School of Medicine.