Nov 8, 2019

OTC Primatene Mist is Back!

Keith Varnes

On November 8, 2018 the FDA
approved Primatene
Mist (epinephrine) to provide temporary relief for symptoms of mild,
intermittent asthma. If you have taken our course Classification and Management
of Asthma you should know that mild, intermittent asthma means the patient has
symptoms no more than twice per week. If they are having symptoms more than
twice per week, they have persistent asthma and should see a specialist.

Many of us older RTs will remember the
Primatene Mist commercials from when we were kids, this is a re-introduction of
the same drug, so now you can expect to see them again. While the drug is the
same, the device has been redesigned using HFA instead of the original CFC.

I see patients all the time that are non-compliant with their medications, usually due to costs, and are now in the hospital. According to, the average cost of Ventolin HFA is $45-$72, $30-$50 with discounts. Hopefully the OTC version will be much cheaper. Welcome news for many patients.

Be aware that the American Association for
Respiratory Care (AARC) has stated that it is extremely concerned about this
latest action that designates Primatene Mist for OTC and the impact it could
have on patients with Asthma. Patients who opt to self-treat their asthma or
asthma symptoms will be doing so without the clinical guidance of the physician
and respiratory therapist.

The concerns of the AARC are valid, but for patients who can’t afford albuterol HFA Primatene Mist OTC might be better than nothing.

Click the links below for more information:

FDA statement on approval

1980s Primatene Mist commercial

CBS news story

GoodRX – albuterol/ventolin prices

AARC statement of concern

Learn More

To learn more about airway pharmacology, take our class Current Issues in Airway Pharmacology for 1.5 AARC approved live CRCE hours. (Use discount code airpharm for 15% off!).

Keith Varnes

Keith Varnes, RRT-NPS, RRT-ACCS, AE-C, is the company founder, President, and chief visionary of Respiratory Associates. He creates content for our Live and Real-Time Live Broadcast continuing education courses. He has been in the respiratory field since 1983 enjoying a diverse career including DME, software development, agency staffing, and working at a level 1 trauma center. He is also an ACLS and PALS instructor.

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