The FDA approved the first inhaled insulin, Exubera from Pfizer, in January 2006. It became available that September, 84 years after the first insulin injections were given. It was approved for those over 18 years of age with diabetes, but realistically was only appropriate for those who could handle large doses. Unfortunately, Exubera was removed from pharmacy shelves in October 2007 after it failed to gain the acceptance of patients and physicians. This failure occurred largely due to the bong-sized inhaler that it required. The inhaler weighed about 4 ounces and was about 12 inches long during delivery.
Regardless of which inhalant is used, inhaling vapours or gases can lead to injury or death. One major risk is hypoxia (lack of oxygen), which can occur due to inhaling fumes from a plastic bag, or from using proper inhalation mask equipment (., a medical mask for nitrous oxide) but not adding oxygen or room air. Another danger is freezing the throat. When a gas that was stored under high pressure is released, it cools abruptly and can cause frostbite if it is inhaled directly from the container. This can occur, for example, with inhaling nitrous oxide. When nitrous oxide is used as an automotive power adder , its cooling effect is used to make the fuel-air charge denser. In a person, this effect is potentially lethal). Many inhalants are volatile organic chemicals and can catch fire or explode, especially when combined with smoking. As with many other drugs, users may also injure themselves due to loss of coordination or impaired judgment, especially if they attempt to drive.
Discuss whether a change in controller medication or decrease in the dose or strength of the inhalant would be an option. Some health experts have reported a reduction in hoarseness after backing down the dose, but this is not always effective. There is a particular inhaled steroid which is inactive until it reaches the surface of the lung (after inhalation). It seems to be an ideal inhalant for people who have adverse effects which are localized to the throat or tongue. The brand name of this unique inhaled steroid is Alvesco. It is only available by prescription. Unfortunately no currently available steroid based inhaler, (including Alvesco) eliminates the risk of dysphonia. One study referenced below suggested reduced risk with some dry powder inhalers.