For a long time, people living with asthma relief 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.
OTC Asthma Inhalers and Medications
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:
- Increased blood pressure
- Nausea or vomiting
- Rapid heartbeat
- Tremor or shaking
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 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
- High blood pressure
- Nervousness or anxiety
- Rapid or irregular heartbeat
- Shortness of breath
- Tremor or shaking
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:
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.
The average cost for Primatene Mist HFA is $30. Primatene Mist HFA can be purchased at most pharmacies. It is available in stores like Walgreens, CVS, and Walmart pharmacy. It is also available in smaller drug stores and even online through pharmacy websites and Amazon.
The medication asthmanefrin is available for purchase through Walmart or asthmenefrim.com It generally costs around $30. Asthmanefrim must be given through a nebulizer. Nebulizers are available for purchase through medical supply stores, drug stores, and online. Depending on the type of nebulizer you prefer, you could spend between $30-$90.
OTC inhalers can help manage mild symptoms of asthma, and they have the benefit of costing less. You also don’t need to see a medical provider to get one, so that is also a cost saving. Mild asthma is qualified as wheezing, tightness of the chest, and shortness of breath that is relieved within 20 minutes of using the OTC inhaler.
If you require eight or more inhalations in 24 hours, or if you are experiencing more than two asthma attacks in a week, your asthma is not mild, and you need a prescription inhaler.
Some people with asthma require stronger medications that can only be purchased with a prescription. A person with moderate to severe asthma may require multiple prescription inhalers. Maintenance inhalers are used daily to prevent an asthma attack from occurring. Some of these inhalers cost $300 or more.
Rescue inhalers that use generic drugs may cost around the same as an OTC inhaler. However, some brand-name rescue inhalers cost about twice as much. Which type of inhaler you need depends on the severity of your asthma. If you have doubts, it’s always better to get advice from a medical professional.
Side Effects of OTC Asthma Inhalers and 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.
Side effects of OTC inhalers can include:
- Slow or fast heartbeat
- Blurred vision
- Double vision
- Trouble speaking
- Chest pain or discomfort
- Inability to move the arms, legs, or facial muscles
- Pounding in the ears
- Pain or discomfort in the arms, jaw, neck, or back
Although some homeopathic remedies claim to treat asthma, the Federal Food and Drug Administration warns that these products have not been evaluated by the FDA for effectiveness and safety.
The FDA goes on to say that relying on these remedies puts a person at risk of requiring emergency care or hospitalization.
When to See a Medical Provider
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
- 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
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Frequently Asked Questions
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.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Asthma and Children Fact Sheet (2018).
Asthmanefrin- Racepinephrine Hydrochloride Solution (2021).
CDER Conversation: Safely Using the Newly Available OTC Asthma Inhaler Primatene Mist. (2018).
FDA Statement on Approval of OTC Primatene Mist to Treat Mild Asthma. (2018).
Learn How To Control Asthma. (2018).
Primatene® MIST Drug Facts. (2019).
Over-the-Counter Medicine Not the Best Option for Asthma. (2014).