Maxair AutoHaler Warning

Maxair Autohaler (pirbuterol) problems. Read this before using the Maxair Autohaler.
  In January 2001, 3M replaced the Maxair (Pirbuterol) metered dose inhaler (MDI) with a new device called an Autohaler. Although this decision was well-intentioned, I believe it was a mistake to discontinue the MDI.

The old metered dose inhaler was much better than the new Autohaler because the user knew for sure if it misfired.  If it did misfire, the user just took another hit.

With the new Autohaler device the user pops a pressure lever that expels the medicine into a staging chamber at the bottom of the device. Then, the user's inhalation opens a small flap that allows the aerosol to pass into the user's mouth.

This sounds like a great idea, except for one big problem.  If it the device misfires, the user doesn't know it.  With the old metered dose inhalers you knew if it misfired because you didn't feel the aerosol shoot into your mouth.  With the new Autohaler the canister expels the aerosol into the staging chamber before it enters the user's mouth, so you can't feel the spray...whether it works or not.

The first time I used the Autohaler I didn't think it was working. I ended up taking six or seven hits before I realized it was working (note: I really don't recommend you try taking six or seven hits of pirbuterol ... even for fun). The next time I used the Autohaler it misfired. I thought it was working, but it wasn't. About half an hour into my ice hockey game was wheezing and panting. Fortunately, I still had an old MDI of Maxair in my hockey bag. 

To prevent this problem, 3M suggests that the user "prime" the Autohaler if it has not been used for 48 hours. This is accomplished by firing it twice without putting your mouth over the device, then putting your mouth over the device for the third puff. That's wonderful. But if you use the inhaler once or twice a week (like I do), then you end up wasting 2/3 of the aerosol in the priming process. According to the 3M website:

  • There are 400 inhalations in the Maxair Autohaler, twice that of other "reliever" inhalers

That's true. But by requiring the user to prime the Autohaler you only get 133 of those 400 inhalations. The other 266 get sprayed into the air. At sixty dollars a canister, your wasting $40 just to get $20 worth of medicine (okay, so my insurance company is wasting $40 to get $20 worth of medicine...but we all do what we have to do to help lower insurance costs).


I would give anything to convince 3M to continue delivering Maxair in the old MDI's.


So, that's my rant. Thanks for listening.

Email me if you have any comments or similar experiences or if you'd like to help me convince 3M to re-release Maxair in the MDI device.

Andy Frazer
Sunnyvale, CA 94087


P.S. According the Food and Drug Administration, 3M has a bit of sordid history of making false claims about the benefits of the Maxair Autohaler.