More than 26 million Americans, roughly 8 percent of the population, have been diagnosed with asthma. In this condition, airway inflammation can lead to constriction. People may cough, wheeze and find it very difficult to breathe. Not only is this frightening, it can also be dangerous. However, when people are able to manage the symptoms of asthma, they can lead reasonably normal lives. Most asthma treatments are available by prescription only. One over-the-counter product, Primatene Mist, has recently returned to drugstore shelves.
Whatever Happened to Primatene Mist?
Q. I have had asthma for over 50 years and have been using an epinephrine inhaler since it came on the market in the mid 1950s. This allowed me to live a normal life.
I was extremely disappointed when Primatene Mist was taken off the market. The drugs my doctor prescribed didn’t work nearly as well. Whatever happened to it?
Epinephrine Is the Active Ingredient in Primatene Mist:
A. For more than a century, people with asthma have used epinephrine (adrenaline) to open their airways. In the mid-1950s epinephrine inhalers became available; Primatene was marketed starting in 1967. It was sold without a prescription until 2011.
Many people wondered why Primatene Mist disappeared at that time. The CFC propellant used to push the medicine into the lungs was banned by international treaty because it depletes ozone from the atmosphere.
In November of 2018 the FDA approved an alternative formulation with a different propellant. Primatene Mist is now back on pharmacy shelves and is the only over-the-counter medicine available for mild, intermittent asthma symptoms.
When Is It Appropriate to Use Primatene Mist?
Some doctors believe that asthma is far too serious for patients to treat on their own. They worry that if people rely on this OTC option that they may not get the preventive treatment they need, such as regular inhaled steroid medications to calm airway inflammation. The FDA defends its decision to return Primatene Mist to pharmacies as part of its push to make more products available without prescription. The agency does not see this product as a replacement for prescription asthma treatment.
We urge you and others who plan to use Primatene Mist for mild asthma to discuss this thoroughly with their physician first. Primatene Mist is only for treating asthma, not for other conditions that can cause wheezing. It is to be used for the temporary relief of mild symptoms, not as a sole treatment nor for a severe flare-up. If you need more than eight inhalations in the course of a day or if your breathing is not better within 20 minutes of using this medicine, you should seek medical attention promptly. Some medicines for Parkinson’s disease, depression or other conditions react badly with epinephrine. The FDA has offered further information here.