A reader’s question got me thinking today. With albuterol inhalers costing about $50 a pop, not to mention maintenance inhalers at $100-$200 per month, and with Primatene Mist now off the market, is there any way an asthmatic can prep on a budget?
If your doctor is agreeable, the answer is yes.
Ipratropium nebulizer solution, as well as several forms of albuterol (2-mg and 4-mg tablets, syrup, and nebulizer solution), are all listed on the $4 prescription drug lists. The nebulizer solutions do require a nebulizer, but these are available without a prescription for as little as $40, though $70 to $100 is more typical.
A good supply of prednisone in several strengths is available for under $10 as well. Prednisone is best reserved for flares of asthma or COPD. Daily use can lead to elevated blood sugars, weight gain, stomach irritation, and weak bones.
Aminophylline, an older asthma medicine, is equally inexpensive. In the days before the plethora of inhalers we know enjoy, aminophylline was the mainstay of asthma therapy. It has been given both orally and IV, and is prone to cause nausea, rapid heartbeat, insomnia, anxiety, and tremor – especially in higher dosages (much like caffeine, to which it is related).
It probably would not be too difficult to get your doctor to prescribe the inexpensive nebulizer solutions. Patients often keep these on hand for exacerbations of asthma or COPD (when properly instructed in their use). The prednisone and/or aminophylline might be a hard sell – again that depends on the doctor-patient relationship and is a matter of trust. (see http://armageddonmedicine.net/?p=3245).
Caffeine and pseudoephedrine are weaker bronchodilators but have the advantages of being both inexpensive and available over the counter.
The trend in asthma care today is to use inhalers (and Singulair) almost exclusively, despite the cost, which often exceeds $200/month for the self-pay patient. Stockpiling a year of extra medicine could easily cost thousands of dollars, at least using current treatment. For end-of-life-as-we-know-it concerns, it may be more cost-effective to purchase the older, inexpensive medications listed above if your doctor is agreeable. Purchase a peak flow meter as well, while you’re at it. Future posts will address treating asthma on your own.
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Copyright © 2012 Cynthia J. Koelker, MD