What Are the Best Over-the-Counter Inhalers?
Key takeaways:
There aren’t many over-the-counter (OTC) inhalers available. Options include Primatene Mist (epinephrine), Asthmanefrin (racepinephrine), and Vicks Sinus Inhaler.
Primatene Mist and Asthmanefrin should only be used for mild asthma symptoms. They both should provide symptom relief within 20 minutes of use.
The Vick Sinus Inhaler is a handheld humidifier. It can be helpful for symptoms of a cold or the flu. It’s not appropriate for treating asthma symptoms.
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Wheezing and tight airways are symptoms of both asthma and a chest cold. Inhalers are often go-to medications to help relieve these symptoms. But most inhalers require a visit with a healthcare professional and a prescription.
So what happens if it’s after office hours and you can’t get a hold of your prescriber? Or perhaps you’re unable to afford your prescription inhaler? Many people wonder if there’s an over-the-counter (OTC) inhaler they can grab from their local pharmacy. Well, OTC inhalers do exist, but options are limited.
Are there any inhalers available OTC?
Yes, there are OTC inhalers available. But they don’t contain the same medications found in common prescription inhalers, such as albuterol (Ventolin HFA). So they may not be the best option for you, depending on your symptoms and medical history.
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Before trying an OTC inhaler, it’s a good idea to discuss them with your prescriber or pharmacist.
What OTC inhalers are available?
There are three OTC inhalers available. One of the inhalers we’ll discuss below doesn’t contain any medication. OTC inhalers are typically found with cough and cold products at your pharmacy.
Primatene Mist
Primatene Mist contains the active ingredient epinephrine. Epinephrine is an adrenergic receptor agonist. Adrenergic receptors (chemical binding sites) are found throughout the body and are involved in many functions, including blood pressure and breathing regulation.
The epinephrine in Primatene Mist attaches to adrenergic receptors in your lungs. This causes your lung muscles to relax and helps open your airways. So in short, Primatene Mist helps make it easier to breathe.
Primatene Mist should only be used for mild, short-term asthma symptoms. This OTC inhaler isn’t FDA-approved for children under 12 years old. It’s also not approved to help relieve symptoms of chronic obstructive pulmonary disease (COPD).
The recommended dosage for Primatene Mist is 1 to 2 puffs every 4 hours as needed. You should only use a total of 8 puffs in a 24-hour period. You should feel the effects of the inhaler within 20 minutes.
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Asthmanefrin
Asthmanefrin contains racepinephrine, a medication very similar to epinephrine. It has the same effects in the body for mild asthma symptoms as Primatene Mist. It’s often advertised as a substitute for Primatene Mist, but it’s not technically a generic version. It’s just a very similar OTC inhaler.
Asthmanefrin can be used for mild asthma symptoms in adults and children ages 4 years and older. As with Primatene Mist, it’s not labeled to treat COPD symptoms.
The recommended dosage is 1 to 3 puffs every 3 hours as needed. You shouldn’t use more than 12 puffs in 24 hours. Similar to Primatene Mist, the medication should take effect within 20 minutes of a dose.
Vicks Sinus Inhaler
The Vicks Sinus Inhaler is a bit different from the two we’ve discussed. This inhaler isn’t really an inhaler at all. It’s a handheld humidifier. But because the product’s name includes the word “inhaler” on the package, it can be confusing when you’re weighing your options.
The Vicks Sinus Inhaler provides 5 to 15 minutes of warm steam directed towards your mouth and nose for you to breathe in. Retailers may carry a generic version of these devices, but they all work similarly.
The Vicks Sinus Inhaler may be helpful when treating a stuffy nose or to help break up mucus. So if you have a cold or the flu, it may help ease your symptoms. It’s not an appropriate treatment for asthma or COPD.
The Vick Sinus Inhaler provides a medication-free option for people looking to avoid cold medicines. However, this device also allows you to place one of their Vicks VapoPads inside it. These provide various scent options like menthol or eucalyptus, which some people prefer when they’re not feeling well.
Is one OTC inhaler better than the others?
If you’re experiencing mild asthma symptoms, Primatene Mist and Asthmanefrin are the two products labeled for the condition. You shouldn’t use the Vicks Sinus Inhaler in this case. But as far as which one’s better, there’s a lack of information directly comparing Primatene Mist to Asthmanefrin. So all we can say is that they provide similar effects for mild asthma.
If you have allergies, a cold, or the flu, you should contact a healthcare professional before using Primatene Mist or Asthmanefrin. These inhalers are only labeled to relieve mild asthma symptoms. But humidifiers, including the Vicks Sinus Inhaler, are one of a number of natural cold and flu remedies you can try.
What side effects can you expect from OTC inhalers?
The biggest side effect of Primatene Mist and Asthmanefrin is that they can raise your blood pressure and heart rate. If you have a heart condition, including high blood pressure, discuss using these OTC inhalers with a healthcare professional first. These inhalers can also cause tremors, nervousness, and, in rare cases, seizures. If you experience any of these side effects, stop using Primatene Mist or Asthmanefrin and talk to a healthcare professional.
The Vicks Sinus Inhaler doesn’t really have “side effects,” since it doesn’t contain medication. However, you should be sure to regularly clean the device in between uses to help prevent a build-up of bacteria and fungi. You should also be wary of the hot steam while using it. The device heats up water and can cause burns if not used appropriately. Read the device’s user manual for more instructions on proper use and maintenance.
When should you see a healthcare professional for an inhaler?
If you’ve been told you have moderate or severe asthma, OTC inhalers probably aren’t the best option for you. Similarly, if you’ve ever been hospitalized for asthma symptoms, you shouldn’t use OTC inhalers without a healthcare professional’s OK. Asthma can be life-threatening for some people if left untreated.
If you’ve tried an OTC inhaler and haven’t noticed improvement, reach out to a healthcare professional to discuss next steps. If you’re unable to get in touch with your prescriber, there are telehealth services available for people with asthma. And if you’re just looking for a refill on an existing prescription inhaler, GoodRx Care can help you out.
Frequently asked questions
No, Primatene Mist is not the same as albuterol. It contains the active ingredient epinephrine (an adrenergic receptor agonist). Albuterol is a different type of medication called a short-acting beta-agonist. It attaches to beta receptors in the lungs and airways. This action helps relax the muscles in these areas, helping to open your airways and breathe easier.
A nebulizer could potentially be a substitute for an inhaler. A nebulizer is a machine that turns liquid medication into a vapor that you inhale. They take longer to use than inhalers per dose. You’ll also have to wear a mask that covers your nose and mouth or close your lips around a mouthpiece while using it. They can be a good option for people who have trouble using an inhaler, such as young children.
The bottom line
Over-the-counter (OTC) inhalers can be a temporary option for relieving mild asthma symptoms, like wheezing. Primatene Mist (epinephrine) and Asthmanefrin (racepinephrine) are two similar inhalers you can buy without a prescription. The Vicks Sinus Inhaler is a handheld humidifier that provides a medication-free option for people looking to ease symptoms of a cold or the flu.
OTC inhalers aren’t the best option for people with moderate or severe asthma. In this case, you should talk to a healthcare professional about treatment options.
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References
Armstrong Pharmaceuticals, Inc. (2024). Primatene mist- epinephrine inhalation aerosol [package insert]. DailyMed.
Asthma and Allergy Foundation of America. (2024). Asthma facts and figures.
Farzam, K., et al. (2023). Adrenergic Drugs. StatPearls.
Feldman, W. B., et al. (2022). Switching to over-the-counter availability of rescue inhalers for asthma. Journal of the American Medical Association.
MedlinePlus. (2019). Epinephrine oral inhalation.
Nephron Pharmaceuticals Corporation. (2021). Asthmanefrin- racepinephrine hydrochloride solution [package insert].
United States Environmental Protection Agency. (2024). Use and care of home humidifiers.
Vicks. (2022). SinusInhaler: Personal steam inhaler: Use and care manual.
