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 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.
- 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.
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:
- 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.
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:
- Loss of appetite
- 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.
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.
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
- 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
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). https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/learn-about-asthma/asthma-children-facts-sheet
Asthmanefrin- Racepinephrine Hydrochloride Solution (2021). https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm
CDER Conversation: Safely Using the Newly Available OTC Asthma Inhaler Primatene Mist. (2018). https://www.fda.gov/drugs/news-events-human-drugs/cder-conversation-safely-using-newly-available-otc-asthma-inhaler-primatene-mist
FDA Statement on Approval of OTC Primatene Mist to Treat Mild Asthma. (2018). https://www.fda.gov/news-events/press-announcements/fda-statement-approval-otc-primatene-mist-treat-mild-asthma
Learn How To Control Asthma. (2018). https://www.cdc.gov/asthma/faqs.htm
Primatene® MIST Drug Facts. (2019). https://www.primatene.com/drug-facts.aspx
Over-the-Counter Medicine Not the Best Option for Asthma. (2014). https://pharmacy.ufl.edu/2014/05/09/over-the-counter-medicine-not-the-best-option-for-asthma/