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Do the new asthma inhalers work as well as the old ones?

Yes, but they may take some getting used to.

For years, the propellant in inhalers was chlorofluorocarbon. The CFC helped push the active drug, such as albuterol, out of the canister and into the airways, making breathing easier for people with asthma. But CFCs damage the earth's ozone layer and have therefore been eliminated from many products.

Now that good alternative inhalers are available, the US Food and Drug Administration has ruled that CFC inhalers may not be sold after Dec. 31.

The CFC-free inhalers use a different propellant, called HFAs, or hydrofluoroalkanes, which do not damage the ozone layer. But the new inhalers taste and feel different.

"And the blast may feel softer, so patients may think they are not getting enough," said Dr. Frederic Little, a pulmonologist, allergist, and critical care specialist at Boston Medical Center.

The smaller albuterol particles in the HFA inhalers may actually allow more of the drug to get into tight airways, Little said.

"Patients should absolutely not worry" about the new inhalers, said Dr. Aaron Waxman, a pulmonologist and critical care specialists who directs the pulmonary vascular disease program at Massachusetts General Hospital. "The delivery system is more accurate - it deliver the medicine right to the area of the airway where it is needed."

The wise thing to do is "to transition now while both kinds of inhalers are still available," said Little. In other words, give yourself time to get used to the new inhalers.