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Since there is no known cure for asthma, treatment options can only address symptoms. There are a variety of prescription medications that can ease symptoms: Some reduce inflammations and swelling in your airways, while some help you breathe easier by relaxing your airways.

Some prescription inhalers are expensive, which has led many people with asthma to consider switching to over-the-counter (OTC) asthma treatment options such as epinephrine, ephedrine, and racepinephrine.

If you’re thinking about changing to an OTC option, discuss the potential move with your doctor. Not only is this generally good advice, but also, if you read the packaging of an OTC inhaler, it clearly states that you should be diagnosed by a doctor before using it.

OTC asthma inhalers are typically not recommended as a replacement for prescription asthma treatment. They are, for the most part, considered viable only for treating mild, intermittent asthma, and they are safe only when used as directed.

Racepinephrine

Racepinephrine (Asthmanefrin) is a bronchodilator that improves breathing by relaxing muscles in the airways. Before taking racepinephrine, check with your doctor, as potential side effects might make it unsafe if you have medical conditions such as:

In 2014, the American Academy of Allergy, Asthma & Immunology indicated that for protection against bronchospasm racepinephrine was less effective than albuterol (Ventolin HFA), a prescription drug used to treat asthma.

Epinephrine

Also known as adrenaline, epinephrine (EpiMist) is a bronchodilator that can open up airways to facilitate breathing. Talk with your doctor before taking epinephrine, as they might suggest avoiding it if you have been diagnosed with:

  • heart disease
  • irregular heartbeat
  • high blood pressure
  • thyroid disease
  • diabetes
  • enlarged prostate with urination problems

Also, your doctor might advise against using epinephrine if you are taking antidepressants. Continued frequent use of epinephrine can lead to tolerance.

Ephedrine

Ephedrine is a bronchodilator that is available OTC as an oral medication in combination with the expectorant guaifenesin. This combination is offered as tablets, caplets, or syrup. Brand names include Bronkaid and Primatene.

Prior to using ephedrine, talk with your doctor to determine if it is appropriate for you and your specific needs. OTC ephedrine typically provides relief for three to five hours. Continued frequent use can lead to tolerance. Common side effects include:

According to the U.S. National Library of Medicine, see your doctor if you take ephedrine and you:

  • do not find relief after 60 minutes
  • have more than two asthma attacks in a week
  • use more than eight doses a day for more than three days a week
  • need 12 doses in a day

While the large majority of cases of asthma can be managed with prescription or OTC treatments, the condition can be life-threatening, so changing medication should not be taken lightly. More than 3,500 people die from asthma every year. Before you switch to an OTC asthma treatment, talk with your doctor about whether or not it is appropriate for you.

Asthma medicines cannot cure asthma, but they can address and help improve your symptoms. Your doctor will most likely recommend that you use specific medication (and dosage) based on a number of factors, including:

  • the severity of your symptoms
  • your triggers
  • your age
  • your lifestyle

It’s critical that you take your asthma medicine precisely as your doctor has instructed: the right medicine (with the proper technique) at the right time.