The shortage of liquid albuterol, a medicine used to treat people with breathing problems such as asthma, is about to get worse. The drug has been in short supply since last summer, says CNN, and a recent shut down by a major supplier to U.S. hospitals has experts even more concerned.

“This is definitely concerning, especially as we are coming out of the respiratory season where we had a big demand with RSV, COVID-19, and flu, and are now heading into spring allergy season when a lot of kids and adults experience asthma symptoms,” said Dr. Janita Mora, national spokesperson for the American Lung Association and an allergist/immunologist based in Chicago. “This is a life-saving drug and being able to breathe is vital for everyone.”

According to Forbes, Akorn Pharmaceuticals, filed for chapter seven bankruptcy and shut down at the end of February, worsening an ongoing drug shortage, especially for U.S. hospitals. There is now only one domestic albuterol manufacturer and that’s Nephron Pharmaceuticals. They began shipping the drug last Friday, but it is now on back order.

What Can Albuterol Users Do During the Shortage?

This is an unfortunate turn of events for the 25 million Americans who suffer from asthma. Albuterol is among the top 10 most prescribed drugs in the U.S., says Forbes. The American College of Allergy, Asthma & Immunology (ACAAI) says that people can use expired inhalers if necessary as they may still be partially effective. If patients can’t get refills, they should contact their healthcare providers and allergists for alternative medications.

The ACAAI warns not to overuse inhalers as one canister should last for months. Hospitals have been closely monitoring their supply of albuterol as they anticipate an uptick of emergency room patients with breathing problems. Some have started compounding, or combining albuterol with other drugs, to create  tailor-made medications for patients. Others have turned to levalbuterol as an alternative, which can also be used in a nebulizer or inhaler to treat breathing problems.

Dr. Patricia Pinto-Garcia, medical editor at GoodRx, offers more ways to navigate the shortage.

• Ask your local pharmacy if they have any version of albuterol in stock. There are brand names and generic albuterol, and both come as inhalers or liquids to use with a nebulizer. They all work equally well. You can take whatever is available, so no need to worry about whether it's okay to take an alternative.
• You can also ask about albuterol alternatives like levalbuterol (Xopenex). They may also be in short supply, but it is always worth asking.
• Ask your healthcare provider if they have any samples, especially if you see a pulmonologist.

GoodRx has more information on inhalers here.