Can You Get an Inhaler Over-the-Counter?

By Zina Semenovskaya, MD
Medically reviewed
September 21, 2021

Over-the-counter medications offer the power to take control of your health and manage mild illnesses.

And today more drugs are being developed for more conditions, including asthma.

For a long time, people living with asthma relied on prescription medications such as asthma inhalers to combat asthma attacks.

In more recent years, the Food and Drug Administration (FDA) has approved a few over-the-counter (OTC) products that can help manage mild symptoms of intermittent asthma without a prescription. 

These OTC medications are not for everyone. In fact, most people should continue to use prescription asthma treatments to keep their symptoms under control. 

To help you determine if an OTC asthma inhaler or other medication may be of use, in this article, I’ll explain the different options as well as their risks.

Keep in mind, you should always talk to a doctor or licensed healthcare provider before you begin any new medical or natural treatment to address your asthma concerns.  

Asthma Basics

Asthma is one of the most common chronic lung diseases in the United States and a leading cause of hospitalizations among children younger than 15 years old. 

When someone has asthma, the airways in the lungs can become triggered and inflamed.

The muscles around the airways can tighten, and the lungs may begin to secrete mucus. Symptoms worsen during an asthma attack, leading to shortness of breath, coughing, wheezing, and other breathing problems.

For people with mild asthma, symptoms are intermittent and quickly resolved. For those with more severe asthma, the condition can be debilitating and, in some cases, life-threatening if not adequately treated. 

Medical experts are not sure what causes asthma.

However, we know that family history, exposure to environmental and occupational hazards such as pollution and chemicals, and medical history of respiratory problems can increase the chances of developing asthma.

Some patients develop the condition as children and continue to experience symptoms as they grow. Others see a change or decline in their symptoms as they move into adulthood.

Still others do not develop asthma until adulthood. 

Asthma is not a curable medical condition, but patients can successfully manage it with the right treatment plan.

If you think you have asthma, the first step is to talk to a doctor about your concerns.

They will evaluate and monitor your symptoms, discuss your condition, and recommend treatment options to help you stave off breathing problems and live a better life. 

People with asthma can use different medications to relieve their symptoms and prevent more severe asthma attacks.

They include:

  • Quick-relief medicine: For patients who need to address symptoms immediately.
  • Controller medicine: For patients who want long-term support for their asthma.
  • Combination quick-relief and controller medicine: For patients who benefit from both short and long-term medications.
  • Biologics: For people with persistent, severe asthma who can’t find relief through other means.

These medications come in the forms of oral tablets or liquids, which are delivered through an inhaler, atomizer, or nebulizer.

When used correctly, these devices act as a propellant, spraying a mist of the medicine into the lungs.

Because asthma is a serious condition that requires consistent medical supervision, most of these treatments are only available by prescription.

However, for people diagnosed with mild asthma, a few treatment options are available over the counter. 

Check your symptoms and get personalized health answers for free

Get Started

OTC Asthma Medication Options

For people diagnosed with mild or intermittent asthma who are under a doctor’s care, over-the-counter inhalers and other products may help augment an existing treatment plan and relieve asthma symptoms.

These medications should only complement the treatments recommended by a doctor and never replace or substitute for them.

FDA-approved over-the-counter asthma treatments on the market include:

  • An inhaler called Primatene Mist HFA
  • A nebulizer liquid solution called Asthmanefrin
  • Oral medications like Bronchial Asthma Relief, Primatene, and others

Primatene Mist HFA

Primatene Mist HFA is a metered-dose inhaler medication produced by China-based drug manufacturer Amphastar Pharmaceuticals.

It contains epinephrine, a bronchodilator that helps open up lung airways and improve breathing.

It is a convenient, recommended asthma treatment for patients who have been diagnosed with mild or intermittent asthma symptoms.

It is also the only FDA-approved asthma inhaler that is currently available over-the-counter in the United States. 

Today’s Primatene Mist was FDA-approved in 2018.

A slightly different, older version of the medication was previously on the market until 2011, before the government recalled it over concerns that the chlorofluorocarbons (CFCs) the inhaler used harmed the ozone layer.

The new version of Primatene Mist includes the same active ingredient (epinephrine) as the original version but uses a new inhaler with a more environmentally friendly propellant to push medication into patient lungs.

Side effects of Primatene Mist HFA include: 

Only adults and children over 12 years of age should use a Primatene Mist inhaler. Primatene Mist is not a replacement for prescription inhalers or the appropriate medication for people who need asthma treatment on a regular basis. 

Primatene Mist can negatively interact with monoamine oxidase inhibitors (MAOIs) and other medications.

It can also put you at risk for heart attack or stroke if you have a history of high blood pressure or heart disease, or take it more often than recommended. 

Asthmanefrin

Asthmanefrin is an over-the-counter medication introduced in 2012 by Nephron Pharmaceuticals to fill a market gap after the original Primatene Mist inhaler was recalled.

The active ingredient, racepinephrine, is a bronchodilator.

The medicine can temporarily relieve mild asthma symptoms like wheezing, shortness of breath, and chest tightness when inhaled through an atomizer. 

Side effects of Asthmanefrin include: 

  • Blurred vision
  • Chest pain 
  • Confusion 
  • Headache 
  • High blood pressure 
  • Nervousness or anxiety 
  • Rapid or irregular heartbeat
  • Seizure 
  • Shortness of breath
  • Tremor or shaking 
  • Vomiting 

Asthmanefrin is not for everyone. It can interact with certain medications and exacerbate existing health conditions.

Talk to your doctor before using Asthmanefrin if you are taking monoamine oxidase inhibitors (MAOIs) or have a history of heart disease, high blood pressure, diabetes, seizure, glaucoma, thyroid issues, or an enlarged prostate. 

Adults and children over four years of age are approved to use Asthmanefrin to address their mild asthmatic symptoms. Patients should limit themselves to 1-3 inhalations every 3 hours.

Do not take more than 12 inhalations in 24 hours. If you are regularly using asthmanefrin and your symptoms do not improve, you may require medical care.

Call your doctor or go to the nearest urgent care for immediate medical attention.

Bronchial Asthma Relief

Bronchial Asthma Relief is one of several oral medications on the market that combines ephedrine (a bronchodilator that opens up your airways) with an expectorant that helps rid your lungs of phlegm.

Other brand names include Bronkaid and Primatene. 

People ages 12 and older can take Bronchial Asthma Relief or other OTC oral medications if they have been diagnosed with asthma and experience mild symptoms.

The recommended dosage is 1-2 tablets every four hours.

You should not take more than 12 tablets in 24 hours unless you are under medical advice.

Side effects of Bronchial Asthma Relief and similar medications include: 

  • Insomnia 
  • Loss of appetite 
  • Nausea 
  • Nervousness or anxiety 
  • Racing heart or irregular heartbeat 

Do not take Bronchial Asthma Relief if you have not been diagnosed with asthma, if you have severe asthma, or if you take regular prescription medication for the treatment of asthma.

This medication can negatively interact with monoamine oxidase inhibitors (MAOIs) and other drugs.

Talk to your doctor if you have high blood pressure, heart disease, a thyroid condition, diabetes, or an enlarged prostate before taking Bronchial Asthma Relief or another OTC asthma medication. 

Potential Risks of OTC Asthma Medication

Asthma is a serious health condition that can be life-threatening if improperly treated or unaddressed.

If you have not been diagnosed with asthma, or if you have chronic or severe asthma, using an over-the-counter inhaler, atomizer, or tablet may not relieve your symptoms.

In fact, misusing an OTC medication when you require more significant intervention may be detrimental to your health because it gives your breathing problems more time to develop into an emergency medical issue.

Over-the-counter asthma medication can also negatively interfere with other prescription medications and exacerbate previous medical conditions.

Talk to your doctor about your asthma and health history before beginning to treat symptoms with any other over-the-counter or alternative treatment. 

Check your symptoms and get personalized health answers for free

Get Started

When to See a Doctor

Asthma is a chronic medical condition, but treatment options can help you successfully manage your symptoms.

Make an appointment to talk to your doctor or another healthcare provider if you are experiencing any symptoms that you believe might be related to asthma, including:

  • Shortness of breath
  • Rapid breath
  • Wheezing
  • Coughing
  • Chest tightness
  • Chest pain
  • Difficulty sleeping

However, if you are experiencing any of the below symptoms, you may be having a severe asthma attack.

Call 911 or go to your nearest emergency room to seek medical attention immediately: 

  • Chest pain 
  • Severe shortness of breath
  • Rapid breathing
  • Difficulty speaking 
  • Feeling weak or faint
  • Feeling forced to use your chest muscles to help you breathe
  • A bluish tinge to your face, mouth, or lips

How K Health Can Help

Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed, text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

Are OTC asthma medications safe to use in an emergency?
Over-the-counter asthma medications and inhalers treat people who have mild, intermittent symptoms. If you are struggling to breathe, are experiencing chest pain, or have any other reason to believe that you are having a severe asthma attack, call your doctor or go to your nearest emergency room immediately.
Are OTC asthma medications the same as prescription medications?
Over-the-counter asthma medications are not the same as prescription medications. They do not have the same ingredients and may harm patients who misuse them for chronic or severe asthma and other conditions.
How can I get my inhaler filled without seeing a doctor?
Primatene Mist HFA is the only FDA-approved asthma inhaler available over the counter in the United States. All other inhaler medications require a prescription. If you would like to take Primatene Mist, talk to your doctor about whether the drug will fit your needs. Never use an over-the-counter inhaler as a substitute for prescription medication or other medical treatment.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Zina Semenovskaya, MD

Dr. Semenovskaya specializes in emergency medicine, and received her medical degree from Weill Cornell Medical College. She is currently the medical director at Remote Emergency Medicine Consulting, LLC and splits her time working clinically as an emergency medicine attending in California and Alaska. She is the first of our doctors to be fluent in Russian.