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Is Over-the-Counter Asthma Medication Available in the United States?

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Updated April 16, 2011

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Over the Counter Asthma Medication- Primatene Mist

Over the Counter Asthma Medication- Primatene Mist

Photo © Davis McNew Getty Images News
Question: Is Over-the-Counter Asthma Medication Available in the United States?
Answer:

Yes. Primatene Mist and other generic epinephrine inhalers are over-the-counter asthma medications available in the United States.

However, all current over-the-counter asthma medications use chlorofluorocarbons (CFCs) as the inhaler propellant -- the activating substance that forces medicine from your inhaler to enter into your lungs when pressed.

Federal environmental laws passed in 2009 have mandated a transition from CFCs to hydroflouroalkane (HFA) in order to decrease ozone levels and protect the environment. As a result, over-the-counter asthma medication using CFC as a propellant cannot be made or sold in the United States after December 31, 2011.

Are Prescription and Over-the-Counter Asthma Medications Different?

Over-the-counter inhalers may only be effective in people with mild intermittent asthma. In people with anything other than mild intermittent asthma, prescription medication is necessary.

Prescription asthma medications like Flovent or albuterol can only be obtained from your asthma doctor. Over-the-counter asthma medication can be obtained without a prescription or a visit to your doctor.

Over-the-counter asthma medication inhalers may taste different than prescription inhalers. Also, patients report that over-the-counter asthma medications like Primatene Mist feel different when inhaled, compared to prescription inhalers.

Prescription inhalers also cost significantly more than over-the-counter asthma medication.

Is Over the Counter Asthma Medication Safe?

A number of safety concerns regarding the sale of over-the-counter asthma medications have been raised by the medical community. Over-the-counter medications are not sold for hypertension, heart disease or cholesterol problems, and we do not allow people to purchase medication without a prescription as many other countries do. As a result, a number of researchers have studied whether or not this practice is safe.

Over-the-counter asthma medication appears safe when used appropriately. An article in the journal Chest found 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 article also found significant numbers people using over-the-counter asthma medication were using the medication inappropriately. Using over-the-counter asthma medication was associated with under-utilizing both inhaled steroids and physician services.

Who Should Use Over-the-Counter Asthma Medication?

Anyone who feels they need to use an over-the-counter asthma medication should probably see a doctor about their symptoms. Asthma is a serious disease that can get worse quickly and asthma may not be causing your symptoms.

According to the packaging for Primatene Mist, for example, you are specifically instructed:

  • Not to use unless you have been diagnosed by a physician.
  • Not to use if you have certain other problems, like heart disease.
  • Not to exceed the recommended dose.

Questions To Ask Yourself Before Using An Over-the-Counter Asthma Medication

Just because a medication is available over the counter does not mean that you should use it. An over-the-counter asthma medication has risks and side effects just like other medications. In fact, a significant number of ER visits are due to side effects of over-the-counter medications.

Sources:

Armstrong Pharmaceuticals. Accessed November 18. Primatene Mist

FDA. Accessed November 18, 2010. Epinephrine CFC Metered-dose Inhalers - Questions and Answers

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. Chest 2000;118;522-526.

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