Getting a prescription inhaler can be a big hassle — you may need to make a doctor’s appointment, wait for insurance approval, and finally run to the pharmacy when it’s ready to pick up. So, what happens if you’re stuck in a pinch without an inhaler and your asthma starts acting up?

Although they don’t have the same ability to control asthma as prescription inhalers, you can easily find over-the-counter (OTC) asthma inhalers in some stores. If your doctor’s office has closed for the day, a quick trip to the pharmacy may help relieve some of your symptoms. OTC inhalers are often less expensive than prescription inhalers, making them an appealing option for some people with mild asthma symptoms.

This article discusses six facts about these OTC inhalers and how they work. We’ll also cover when their use is recommended, how they’re different from prescription inhalers, and when to talk to your doctor about your asthma.

Treating Asthma With an Inhaler

If you or your child has asthma, you likely know that inhalers are commonly used to relieve symptoms. You may be prescribed a rescue inhaler with quick-relief medications, or you may have a maintenance inhaler to prevent asthma attacks.

Rescue inhalers use a bronchodilator, a medication that relaxes and opens the airways. Examples include inhalers such as albuterol sulfate (Proventil, ProAir, Ventolin HFA) and levalbuterol tartrate (Xopenex HFA).

On the other hand, maintenance inhalers use long-acting medications like inhaled steroids to keep your airways open over a longer period of time while reducing inflammation. They’re used daily to treat asthma and prevent your asthma symptoms from flaring.

If you’ve left your rescue inhaler at home on a long trip or if you’ve run out on a holiday weekend, an OTC inhaler might be able to help. Here are six things to know about them.

1. There Are Two OTC Inhalers Available for Treating Mild Asthma Symptoms

Currently, there are two OTC asthma inhalers available on the market in the United States. The U.S. Food and Drug Administration (FDA) approved epinephrine (Primatene Mist) in 2018 for treating mild symptoms of intermittent asthma — that is, asthma that occurs irregularly. It’s intended for people who only occasionally have asthma symptoms and use minimal medication.

The other OTC inhaler option is racepinephrine (Asthmanefrin). It’s important to note that Asthmanefrin doesn’t have FDA approval — because it’s an OTC drug, the FDA simply monitors it for any reported issues or unwanted side effects.

2. OTC Inhalers Cannot Replace Your Maintenance Inhalers

Using less-expensive OTC inhalers to manage your asthma may be tempting, but that’s not their intended use. The FDA states that Primatene Mist should be used only for treating mild symptoms of intermittent asthma. The same instructions are found on the drug label for Asthmanefrin.

If you’re experiencing mild coughing, wheezing, or shortness of breath, an OTC inhaler can help. They work similarly to your rescue inhaler to treat new asthma symptoms quickly. However, these medications aren’t intended to prevent asthma attacks.

If the following situations apply to you, talk to your doctor as soon as possible — they may be signs that you need better asthma treatment:

• Your asthma symptoms don’t improve within 20 minutes of using the inhaler.
• You use the OTC inhaler more than eight times within 24 hours.
• You have two or more asthma attacks within seven days.

3. OTC Asthma Inhalers Contain Epinephrine as the Active Ingredient

Most rescue and maintenance asthma inhalers use bronchodilators, steroids, or a combination of the two. These medications help open your airways, treat asthma symptoms, and prevent asthma attacks.

On the other hand, Primatene Mist uses epinephrine (also known as adrenaline) as a bronchodilator. Epinephrine also helps relax tight airways, making breathing easier. It typically starts working within 20 minutes to relieve mild asthma symptoms like shortness of breath, wheezing, and chest tightness.

The active ingredient in Asthmanefrin is racepinephrine, a slightly different chemical structure of epinephrine that also relaxes your airways.

4. OTC Inhalers May Work Differently Than Your Prescribed Inhaler

Most asthma inhalers use one of three methods to deliver medication to your lungs. There are dry powder inhalers (DPIs), metered-dose inhalers (MDIs), and soft-mist inhalers (SMIs).

Primatene Mist comes as an MDI — if you’re accustomed to using another type of inhaler, be sure to read the provided instructions closely on how to use this type and take only the recommended dose. You should also ask your doctor or pharmacist to show you how to use the inhaler properly.

On the other hand, Asthmanefrin comes as a liquid solution that’s added to a hand-held or portable nebulizer. The nebulizer turns the medication into a fine mist that you inhale into your lungs. Again, be sure to follow the instructions closely and ask for help when needed.

5. You May Experience Some Side Effects After Using an OTC Inhaler

The main ingredient in OTC inhalers is epinephrine or adrenaline, which your body naturally makes during a “fight-or-flight” response. Adrenaline is responsible for your racing heart when you’re scared or nervous.

OTC inhalers can cause the same response — for example, side effects of Primatene Mist include elevated blood pressure and heart rate. It’s best to talk to your doctor before using an OTC inhaler if you have a history of heart disease or high blood pressure. This is because it may raise your risk of a stroke or heart attack.

If your heart is pounding or beating extremely fast, if you’re shaking or have tremors, or if you’re struggling to fall asleep, stop using the inhaler and call your doctor.

6. Unlike Prescription Inhalers, OTC Inhalers Are Relatively Inexpensive

Without insurance, prescription medication costs can quickly add up. If you only need occasional relief from mild asthma symptoms, it might not make sense to buy an expensive medication. OTC inhalers may offer you a less-pricey option if your doctor thinks it’s a safe choice given your current level of asthma control.

The costs of Primatene Mist and Asthmanefrin can vary by store and location, so be sure to check around for the best deal in your area. A quick Internet search shows that both OTC medications cost around $30 to $40.

Ask Your Doctor About Recommendations for OTC Inhalers

Before trying new asthma medications — prescription or OTC — be sure to talk to your doctor or health care provider first. Asthma is a chronic (long-term) condition that often needs close monitoring and individualized care.

OTC inhalers like Primatene Mist and Asthmanefrin try to take a “one-size-fits-all” approach that may work for some people but not others. It’s also important to note that these asthma treatments aren’t listed in the National Institute of Health’s Guidelines for the Diagnosis and Management of Asthma.

The best way to manage your asthma is by working with your doctor. They can provide other recommendations, like tips on avoiding your asthma triggers and creating an asthma action plan in case of an emergency.

Talk With Others Who Understand

On MyAsthmaTeam — the social network for people with asthma and their loved ones — more than 10,000 members come together to ask questions, give advice, and share their stories with others who understand life with asthma.

Have you used an over-the-counter inhaler to manage your asthma? Share your experience in the comments below, or start a conversation by posting on your Activities page.