Asthmanefrin is an over-the-counter bronchodilator used for temporary relief of mild intermittent asthma symptoms, including wheezing, chest tightness, and shortness of breath.

What Is Asthmanefrin?

Asthmanefrin is a brand-name OTC asthma medication containing Racepinephrine Hydrochloride 2.25% as its active ingredient. Racepinephrine is a racemic form of epinephrine (adrenaline) that belongs to the adrenergic bronchodilator drug class.

It's manufactured by Nephron Pharmaceuticals Corporation, based in Orlando, Florida. Asthmanefrin launched in 2012 as an OTC alternative after the original CFC-propelled Primatene Mist was taken off the market.

Key facts at a glance:

• Brand name: Asthmanefrin
• Generic name: Racepinephrine (Racepinephrine Hydrochloride)
• Drug class: Adrenergic bronchodilator
• Manufacturer: Nephron Pharmaceuticals Corporation
• Controlled substance: No — Asthmanefrin is not a controlled substance
• Prescription required: No — it's available over the counter
• Other brands: S2 Inhalant (prescription-grade Racepinephrine used in clinical settings)

What Is Asthmanefrin Used For?

Asthmanefrin is FDA-approved for temporary relief of mild symptoms of intermittent asthma, including:

• Wheezing
• Chest tightness
• Shortness of breath

The key word is intermittent. This means symptoms that happen occasionally—not daily. If you're experiencing asthma symptoms most days or waking up at night due to breathing problems, Asthmanefrin alone is not the right treatment. You likely need a prescription controller medication and a more targeted rescue inhaler like Albuterol.

In clinical settings, Racepinephrine (the active ingredient) is also used off-label for croup in children and upper airway edema, but these uses involve the prescription-grade S2 Inhalant, not the OTC Asthmanefrin product.

How Is Asthmanefrin Taken?

Asthmanefrin comes as an inhalation solution in 0.5 mL single-use sterile vials. It's used with the EZ Breathe Atomizer, a hand-held bulb nebulizer included in the starter kit.

Here's how to use it:

1. Open one vial of Asthmanefrin solution (0.5 mL).
2. Add the contents to the EZ Breathe Atomizer.
3. Squeeze the bulb to create a fine mist and inhale 1 to 3 inhalations.
4. Wait. Symptoms should begin to improve within 20 minutes.

Dosage limits:

• 1–3 inhalations per dose
• Do not use more often than every 3 hours
• Maximum: 12 inhalations in 24 hours
• For adults and children aged 4 years and older
• Children must be supervised by an adult

If your symptoms don't improve within 20 minutes, don't take more Asthmanefrin. Seek medical help—this could be a sign of a severe asthma attack.

Who Should Not Take Asthmanefrin?

Asthmanefrin is not safe for everyone. Do not use Asthmanefrin if you:

• Have taken an MAO inhibitor (such as Isocarboxazid, Phenelzine, Rasagiline, Selegiline, or Tranylcypromine) within the past 14 days — this is a dangerous interaction
• Are allergic to Racepinephrine or Epinephrine

Talk to a doctor before using Asthmanefrin if you have:

• Heart disease or high blood pressure
• Diabetes
• Thyroid disorder
• Seizures or epilepsy
• Narrow-angle glaucoma
• Enlarged prostate with urination problems
• Mental illness or emotional disorders

Children under 4 years old should not use Asthmanefrin without consulting a doctor. Pregnant and breastfeeding women should also consult a healthcare provider, as the effects on unborn babies and infants aren't fully known.

For a complete list of what to watch out for, read our guides on Asthmanefrin side effects and drug interactions.

How Much Does Asthmanefrin Cost?

Since Asthmanefrin is an OTC product, it's generally not covered by health insurance. Here's what you can expect to pay out of pocket:

• Starter Kit (EZ Breathe Atomizer + 10 vials): $35–$50
• 30-count Refill Box: $30–$75

Prices have increased over the years, with some retailers and online sellers charging $70–$75+ for refill packs. Prices on Amazon can fluctuate significantly.

There is no generic equivalent of the Asthmanefrin OTC product, and Nephron Pharmaceuticals does not currently offer a manufacturer savings program or patient assistance program.

However, Asthmanefrin is HSA/FSA eligible—you can use pre-tax health savings or flexible spending account funds to buy it, which effectively saves you 20–30% depending on your tax bracket.

For more cost-saving strategies, check out our guide on how to save money on Asthmanefrin.

How Does Asthmanefrin Compare to Other Asthma Medications?

Asthmanefrin occupies a unique niche as one of only two OTC asthma inhalers in the United States:

• Primatene Mist (Epinephrine) — The other OTC option. It's a metered-dose inhaler (no nebulizer needed) for ages 12+. It's more convenient but works through a similar mechanism.
• Albuterol (ProAir, Ventolin, Proventil) — The gold standard prescription rescue inhaler. More targeted beta-2 selectivity means fewer cardiovascular side effects. Requires a prescription.
• Levalbuterol (Xopenex) — Prescription alternative, potentially fewer side effects than Albuterol.
• Ipratropium (Atrovent) — Prescription anticholinergic bronchodilator, often used as add-on therapy.

Asthmanefrin's biggest advantage is accessibility—you can buy it without a prescription or doctor visit. Its biggest limitation is that it's less targeted than prescription inhalers and may cause more cardiovascular side effects. Learn more in our mechanism of action guide.

Final Thoughts

Asthmanefrin is a legitimate OTC option for people with mild, intermittent asthma who need quick relief from wheezing and shortness of breath. It's accessible, doesn't require a prescription, and works within about 20 minutes.

But it's not a replacement for proper asthma care. If you're using it more than twice a week, your asthma needs more management than an OTC inhaler can provide. See a doctor for an asthma evaluation.

Need to find Asthmanefrin near you? Medfinder can help you check which pharmacies have it in stock.