Primatene Mist
Primatene Mist (epinephrine) is an over-the-counter (OTC) bronchodilator spray used for short-term relief of mild asthma symptoms, such as wheezing, shortness of breath, and tightness in the chest. It's available as an aerosolized (mist) inhaler with epinephrine as the active ingredient. Side effects include raised blood pressure or heart rate and nervousness.
What is Primatene Mist (epinephrine)?
What is Primatene Mist (epinephrine) used for?
Asthma, short-term relief of mild symptoms in adults and children ages 12 and older
How Primatene Mist (epinephrine) works
Primatene Mist (epinephrine) is an alpha and beta adrenergic agonist. It works by attaching to certain receptors that cause the lung muscles to relax, which opens up your airways so you can breathe more easily.
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What are the side effects of Primatene Mist (epinephrine)?
Common Side Effects
- Fast heartbeat
- Tremors
- Nervousness
Other Side Effects
- Trouble sleeping
Serious Side Effects
- Heart problems: dizziness, fatigue, weakness, tremor, irregular heartbeat, worsening symptoms of existing heart problem
Source:Â DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Less common
Blurred or decreased vision
Symptoms of too much medicine being absorbed into the body
Fast, irregular, or pounding heartbeat
feeling faint
increased sweating
paleness
trembling
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Eye pain or ache
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Primatene Mist (epinephrine)
Pros
Provides short-term relief of shortness of breath, wheezing, and chest tightness
One of few inhaler options available over the counter
Can be used in people ages 12 years and older
Cons
Can raise blood pressure and speed up your heart rate
Not meant for long-term use
Not a preferred medication for asthma because of the potential risk of heart-related side effects
Pharmacist tips for Primatene Mist (epinephrine)
Primatene Mist (epinephrine) can interact with other prescription and over-the-counter medications. Don't start taking Primatene Mist (epinephrine) without first talking to your provider or pharmacist first to see if the medication is right for you.
Stop using Primatene Mist (epinephrine) and contact your provider if you don't get any relief after 20 minutes, you need more than 8 doses in 24 hours, or have 2 or more asthma attacks in one week. These might be signs of a more serious medical condition that you'll need to get checked out.
You'll need to prime your brand new Primatene Mist (epinephrine) inhaler before you use it for the very first time. This is done by shaking the inhaler and then spraying it into the air away from you 4 times.
Wash your inhaler at the end of each day you use Primatene Mist (epinephrine) by running water through the mouthpiece for 30 seconds. You don't have to wash it on days when you don't use it.
Store Primatene Mist (epinephrine) at room temperature. Don't store it near an open flame or heat above 120°F because the inhaler can burst.
How to use Primatene Mist (epinephrine):
Read the instructions for use or watch these helpful videos to learn how to use the medication properly.
Always remove the red cap before spraying your Primatene Mist (epinephrine) inhaler. Shake your inhaler and then spray once into the air before each use to make sure you get a full dose. Then, exhale completely before placing the inhaler in your mouth. When you're ready, take a deep breath in while pressing down on the top of the inhaler.
Try to hold your breath for as long as you comfortably can. This allows time for Primatene Mist (epinephrine) to reach deep into your lungs.
After you exhale, wait 1 minute to see if your symptoms improve. If you're still having symptoms, you can take a second inhalation. Wait at least 15 seconds between inhalations.
Frequently asked questions about Primatene Mist (epinephrine)
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What are the risks and warnings for Primatene Mist (epinephrine)?
Primatene Mist (epinephrine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Worsening asthma symptoms
Primatene Mist (epinephrine) can provide short-term relief from mild asthma symptoms. But if your symptoms get worse or don't improve after 20 minutes, get medical help right away. You should also see a provider about your asthma if you need to use Primatene Mist (epinephrine) more than 8 times in one day or if you have more than 2 asthma attacks in one week.
Heart problems
Risk factors: High blood pressure | Heart rate or rhythm problems | Using more Primatene Mist (epinephrine) than recommended | Using other medications that raise your heart rate and blood pressure | Caffeine intake
Primatene Mist (epinephrine) can raise your blood pressure and heart rate. If you have high blood pressure or other heart problems (e.g., atrial fibrillation), Primatene Mist (epinephrine) can make it worse, especially if you take the medication more often than recommended. Watch out for worsening signs and symptoms of your heart condition. Tell your provider if you develop dizziness, fatigue, tremor, rapid heartbeat, or weakness while taking Primatene Mist (epinephrine).
Worsening of medical conditions
Risk factors: Previous hospitalization for asthma | Heart disease or high blood pressure | Thyroid problems | Diabetes | Glaucoma | Urinary problems | Seizures
Don't take Primatene Mist (epinephrine) if you have any of the risk factors listed above unless your provider says it's safe to do so. Taking Primatene Mist (epinephrine) can worsen your condition(s) and cause serious side effects. Make sure your provider knows about all medical conditions you have or have had in the past before starting Primatene Mist (epinephrine).
Primatene Mist (epinephrine) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 160 metered sprays of 0.125mg/spray | 1 inhaler | $32.77 | $32.77 |
Typical dosing for Primatene Mist (epinephrine)
The typical dose is 1 to 2 sprays inhaled through the mouth every 4 hours as needed. Don't use more than 8 sprays in 24 hours.
Interactions between Primatene Mist (epinephrine) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
How much does Primatene Mist (epinephrine) cost?
Primatene Mist (epinephrine) contraindications
Not having been diagnosed with asthma
Currently taking, or have taken, an monoamine oxidase inhibitor (MAOI) within the past 2 weeks
What are alternatives to Primatene Mist (epinephrine)?
Asthma, short-term relief of mild symptoms in adults and children ages 12 and older
Treatment or prevention of wheezing or tightening of airways in people ages 4 years and older with certain types of lung problems (e.g., asthma)
Prevention of exercise-induced asthma in people ages 4 years and older
Treatment or prevention of wheezing or tightening of airways in people with certain types of lung problems (e.g., asthma)
What is the latest news about Primatene Mist (epinephrine)?
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References
Best studies we foundAmerican Thoracic Society. (2018). FDA announces approval of otc inhaled epinephrine for treatment of asthma – ATS registers strong concern.
Armstrong Pharmaceuticals, Inc. (2021). PRIMATENE MIST- epinephrine inhalation aerosol [package insert]. DailyMed.
Dalal, R., et al. (2023). Epinephrine. StatPearls.
Hartling, L., et al. (2004). Epinephrine for bronchiolitis. The Cochrane Database of Systematic Reviews.
Kerwin, E. M., et al. (2021). Long-term safety and efficacy studies of epinephrine HFA metered-dose inhaler (Primatene® Mist): A two-stage randomized controlled trial. The Journal of Asthma.
Sadreameli, S. C., et al. (2019). The surprising reintroduction of Primatene Mist in the United States. Annals of the American Thoracic Society.
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