Primatene Mist Uses and Safety

Primatene Mist, as well as other generic epinephrine inhalers, that are powered by chlorofluorocarbons (CFCs) are no longer currently available for the treatment of asthma in the United States. Primatene Mist was approved by the Food and Drug Administration (FDA) for the temporary relief of occasional symptoms of mild asthma.

Beautiful girl with asthma difficulties using inhaler
RgStudio / Getty Images

Many companies have switched propellants from CFCs to hydrofluoroalkane (HFA). HFA inhalers can be used in the same manner as CFC inhalers.

In 2014 an FDA advisory panel voted to not to recommend over the counter marketing for a Primatene Mist HFA inhaler. But after reformulating with HFA propellant and changing the inhaler device, Primatene Mist is once again available over the counter in 2019.

In 2009, federal laws mandated that inhaler propellants (the substance that causes the medicine from your inhaler to enter into your lungs when pressed) change from chlorofluorocarbons (CFCs) to hydroflouroalkane (HFA) in order to decrease ozone levels and protect the environment. This allowed pharmaceutical companies to start increasing costs, as the new propellants were considered a "new drug."

Primatene Mist and other generic epinephrine CFC inhalers were taken off the market in the United States, December 31, 2011.

Other OTC Meds Have Entered the Market

Asthmanefrin is not a CFC or HFA inhaler, but is a device that creates a fine mist that can be inhaled into the lung from a liquid. Single unit doses are placed into the well of the device and the mist is then created and breathed in. You continuously inhale until no more mist is created.

Like Primatene Mist, Asthmanefrin is indicated for the "temporary relief of bronchial asthma, including shortness of breath, tightness of chest and wheezing."

Is Primatene Mist Safe?

Many healthcare providers have concerns about whether it is safe to sell over-the-counter asthma medications. Over-the-counter medications aren't sold for hypertension, heart disease, or cholesterol problems—so many ask, why for asthma? As a result, a number of researchers have studied whether or not this practice is safe.

In general, Primatene Mist appears safe if used appropriately. An article in Chest, the journal of the American College of Chest Physicians, concluded 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 authors went on to point out that 20% of people using OTC epinephrine inhalers like Primatene Mist should not be using them, and should actually be on other asthma medication and under the care of a physician.

Additionally, use of drugs like Primatene Mist has been associated with decreased use of inhaled steroids and under-utilization of physician services.

What Is Primatene Mist Used For?

If you're considering using Primatene Mist, see a healthcare provider first. Asthma is a serious disease that can get worse quickly. You shouldn't use an over-the-counter medication to avoid seeking medical care for asthma.

According to its packaging information, Primatene Mist can be used "for temporary relief of occasional symptoms of mild asthma," such as:

The packaging says to ask a doctor before use if you have:

  • Ever been hospitalized for asthma
  • Heart disease
  • High blood pressure
  • Diabetes
  • Trouble urinating due to an enlarged prostate gland
  • Thyroid disease
  • Seizures
  • Narrow angle glaucoma

Primatene Mist Side Effects

Common side effects of Primatene Mist include:

  • Appetite changes
  • Dizziness
  • Headache
  • Hyperactivity
  • Nausea
  • Nervousness
  • Shakiness
  • Sinus pain
  • Sore throat
  • Tremor
  • Trouble sleeping
  • Vomiting

More Serious Side Effects of Primatene Mist

Some Primatene Mist side effects require you to see a healthcare provider immediately. These would include:

  • Allergic reactions, like rash, hives, difficulty breathing, and swelling of the mouth, face, lips, or tongue
  • Chest pain
  • Ear pain
  • Fast or irregular heartbeat
  • Hoarseness
  • Pounding in the chest
  • Red, swollen, blistered, or peeling skin
  • Severe headache or dizziness
  • Trouble breathing

Buying Primatene Mist & Other Asthma Medications Over the Internet

If you are considering buying Primatene Mist over the intenet, make sure you use a company you can trust. Reputable companies:

  • Are located in the U.S. and licensed by the National Association of Boards of Pharmacy (NABP)
  • Have a licensed pharmacist available to you to address any concerns you have about your asthma medication, just as the pharmacy down the street would
  • Only fill prescriptions for appropriately licensed healthcare providers
  • Do not sell products not approved by the FDA
  • Participate in the Verified Internet Pharmacy Practice Sites (VIPPS) certification program
  • Protect your privacy and keep your personal information safe

Financial Help for Asthma Medications

There are a number of patient assistance programs that can help you obtain free or low-cost asthma medications. The programs are all very different and will have different rules and qualification standards.

Frequently Asked Questions

  • What is the cost of Primatene Mist?

    Primatene Mist costs an average of $35 for 11.7 grams.

  • Is Primatene Mist the same as albuterol?

    No. The active ingredient in Primatene Mist is epinephrine. Albuterol (also known as salbutamol) is only available by prescription.

  • Does Primatene Mist work for shortness of breath?

    Primatene Mist should only be used for mild, intermittent asthma, including shortness of breath. For severe shortness of breath, call 911.

  • How many times a day can you use Primatene Mist?

    According to the Primatene Mist directions, each dose is one to two inhalations, and the maximum daily dose is eight inhalations in 24 hours.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. Food & Drug Administration. CDER conversation: safely using the newly available OTC asthma inhaler Primatene Mist.

  2. OINDP news. FDA approves OTC Primatene Mist for mild asthma.

  3. Velsor-friedrich B, Militello LK, Zinn KK, Dewolff DK. Switching from CFC to HFA inhalers: what NPs and their patients need to know. Am J Nurse Pract. 2009;13(10):45-50.

  4. Young S. No more Primatene Mist in the U.S. after this year. CNN.

  5. University of Florida, College of Pharmacy. Over-the-counter medicine not the best option for asthma.

  6. U.S. Food & Drug Administration. Center for Drug Evaluation and Research. Summary review for regulatory action.

  7. U.S. Food & Drug Administration. Primatene.

  8. Drugs.com. Primatene mist.

  9. U.S. Food & Drug Administration. Buying prescription medicine online: a consumer safety guide.

  10. Primatene.com. Primatene Mist FAQs.

Additional Reading
  • FDA. Epinephrine CFC Metered-dose Inhalers - Questions and Answers

  • Armstrong Pharmaceuticals. 
  • Dickinson BD, Altman RD, Deitchman SD and Champion HC. Safety of Over-the-Counter Inhalers for Asthma. Chest 2000;118;522-526.
  • Kuschner WG, Hankinson TC, Wong HC and Blanc PD. Nonprescription Bronchodilator Medication Use in Asthma. Chest 1997;112;987-993.

By Pat Bass, MD
Dr. Bass is a board-certified internist, pediatrician, and a Fellow of the American Academy of Pediatrics and the American College of Physicians.