Asthmanefrin: An OTC Asthma Inhaler

About This Non-Prescription Asthma Medication

Young boy using asthma inhaler
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Many people choose to use an over the counter asthma inhaler for asthma-like symptoms before actually being diagnosed with asthma. Asthmanefrin is currently marketed as an over the counter alternative to the Primatene Mist CFC inhaler, which is no longer available in the United States.

Chlorofluorocarbons(CFCs) were once the propellant or activating substance, that forced medication from many over the counter and prescription inhalers prior to 2011.

CFCs were banned because they damage the ozone layer and cause environmental damage.

How Asthmanefrin Is Used

According to the package insert for Asthmanefrin:

Asthmanefrin is an over-the-counter medication for the temporary relief of bronchial asthma, including shortness of breath, tightness of chest and wheezing. Asthmanefrin can be administered for patients ages four (4) and older. Asthmanefrin has been used to treat asthma in children and adults for over a hundred years.

The active ingredient in Asthmanefrin is racepinephrine, which acts as a bronchodilator. A bronchodilator relaxes inflamed muscles and functionally enlarges the airways of the lungs. Enlarging the airways improves air flow and thus symptoms.

Asthmanefrin can be used for the temporary relief of asthma symptoms such as:

Asthmanefrin does not work like other inhalers. Rather, it uses a device like the EZ Breathe Atomizer that takes a small amount of liquid and turns it into a fine mist that can be inhaled into the lungs.

Asthmanefrin comes as a prepackaged single unit dose of 0.5 milliliters. The medicine is placed into the well of the atomizer device and the mist is then created and inhaled. The mist is continually inhaled until no more mist is created.

Asthmanefrin Warnings & Controversies

Asthmanefrin should only be used to inhale medication into the lungs through the mouth.

Additionally, you should not use Asthmanefrin if you have not been diagnosed with asthma by a doctor, if a doctor has you on other asthma medications or if you have ever been hospitalized for asthma.

The package insert states that you should not use Asthmnefrin if you have any of the following conditions:

Not all professionals believe over the counter asthma inhalers like Asthmanefrin should be available to consumers. In fact, organizations such as the American College of Asthma, Allergy & Immunology, the American Association for Respiratory Care, the American Thoracic Society and the National Association for Medical Direction of Respiratory Care do not want over the counter inhalers to be included in asthma treatment guidelines because they do not feel that epinephrine products are safe for the treatment of asthma.

These organizations question whether selling these medications over the counter is safe. While many medications have become available over the counter - such as Claritin (allergy medication) and Alli (the OTV version of Xenical) - other medications that are used to treat hypertension, heart disease, and cholesterol problems have not.

There are no studies that have looked specifically at Asthmanefrin safety, but there are several studies of its predecessor: Primatene Mist. It appears that Primatene Mist was safe when used appropriately. However, use of the inhaler was also associated with the under-utilization of physician services and other medications, such as inhaled steroids.

In 2000 one report concludes that “the occasional use of OTC epinephrine inhalers appears to be safe and effective when used according to labeled instruction by individuals with only mild, intermittent disease.” However, the report also stated that 20 percent of people using over the counter epinephrine inhalers like Asthmanefrin have mild-to-moderate persistent asthma.

These patients should be on other asthma medication and under the care of a physician.

You will have to decide for yourself what you think about this readily available OTC asthma inhaler. If you have asthma symptoms, you should see a doctor so that you can be diagnosed and treated appropriately before you take treatment into your own hands.

See Also


Asthmanefrin. Product website. 

Kuschner WG, Hankinson TC, Wong HC and Blanc PD. Nonprescription Bronchodilator Medication Use in Asthma. Chest 1997;112;987–993.

Dickinson BD, Altman RD, Deitchman SD and Champion HC. Safety of over-the-counter inhalers for asthma: report of the council on scientific affairs. Chest 2000;118;522–526.

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