Primatene Mist Back On Market

We thought it was gone for good. But, apparently not. After being banned for seven years, Primatene Mist is now back on the market. Also, as before, it will be available over the counter (OTC). So, anyone can just go to a pharmacy and buy one. They’ll cost around $25 each. So, here’s what to know.1

Why was Primatene Mist initially phased out?

It was the last of the Epinephrine inhalers. These inhalers entered the market in 1957 as the Medihaler Epi. It was sold by Riker Laboratories, Inc, which is now 3M Drug Delivery Systems.2

By the 1980s, it was available as a generic inhaler. It was sold as Primatene Mist. But, it was phased out after the Montreal Protocol was signed in 1987. This protocol was to phase out all inhalers that used Chlorofluorocarbons (CFC) as a propellant.2

To stay on the market Primatene Mist would have to be reformulated. It would have to be mixed with the environmentally friendly Hydrofluorocarbons (HFC) propellant. It would have to go through all the same trials of other new medicines before being re-approved by the FDA.2

An HFA was not available at this time. The inhaler was set to be phased out by 2011. It was the last CFC inhaler to be nixed from the market.2

So, why was Primatene Mist brought back?

I would imagine there was quite a bit of demand for it.

There were some asthmatics who used Primatene Mist for years. For them, it worked just fine. These asthmatics probably just had mild asthma. And occasional puffs of Primatene Mist worked great for relieving their asthma symptoms.

OTC inhalers are also easier to get. They are also less expensive. First, you don’t have to convince a doctor you need one. Second, you don’t have to pay for a doctor’s visit. Third, you just walk into a pharmacy and buy one. It’s that easy.

Is this the ideal way of managing asthma?

No. In fact, most asthma experts frown upon it. Epinephrine inhalers are rescue inhalers. But, they are not as strong as prescription rescue inhalers, like albuterol (Ventolin, Proventil). I know this from personal experience. I bought one once and it took many puffs to open my airways. This is opposed to 1-2 puffs of albuterol.

Epinephrine also doesn't have the same efficacy as albuterol. This is especially true if you use it more than recommended. It has the potential to increase the rate and force of your heart. It can also increase your blood pressure. So, these are side effects doctors worry about.3

What do experts recommend?

If you are having asthma symptoms, you should see a doctor. This way you can get a proper diagnosis. If you don’t have asthma, you may not even benefit from medicines like Racemic Epinephrine. If you do have asthma, a doctor can help you control and prevent asthma symptoms.

So, only a doctor can help you best manage your asthma. A doctor may help you obtain ideal control of your asthma. Asthma control means asthma episodes are rare and very mild when they do occur. So, it can make medicines like Primatene Mist work better.

In my opinion, all asthmatics should have access to a rescue inhaler at all times. Doctors may be inclined to prescribe rescue medicines they feel comfortable with, such as albuterol. However, Racemic Epinephrine is now an option worth discussing with your doctor.

What to make of this?

Primatene Mist HFA is now approved by the FDA. If you can’t yet, it will probably soon be available on store shelves. If you have mild asthma and need an inhaler, it may be a viable option for you. However, the FDA strongly recommends you talk to your doctor first. And they also strongly recommend you don’t use this as an excuse to stop taking medicines you are currently taking to control your asthma.1

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