Comprehensive medication guide to Primatene Mist including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
Primatene Mist is an OTC medication and is typically not covered by insurance or Medicare Part D. If prescribed by a doctor, some plans may reimburse it. FSA and HSA funds can be used for OTC purchase without a prescription.
Estimated Cash Pricing
$39–$54 retail without discounts; as low as $29.01 with SingleCare or $30.05 with GoodRx at a 30-day supply of 1 canister (160 sprays). No generic available.
Medfinder Findability Score
82/100
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Primatene Mist (epinephrine inhalation aerosol, 0.125 mg per actuation) is the only FDA-approved over-the-counter asthma inhaler available in the United States. It is manufactured by Amphastar Pharmaceuticals, Inc. and is approved for the temporary relief of mild symptoms of intermittent asthma — including wheezing, tightness of chest, and shortness of breath — in adults and children 12 years of age and older.
The current version is a hydrofluoroalkane (HFA)-propelled metered-dose inhaler (MDI), approved by the FDA on November 7, 2018. It replaced the original CFC-based Primatene Mist, which was withdrawn in December 2011 due to the Montreal Protocol on ozone-depleting substances. Each canister provides 160 metered actuations (11.7g net weight).
Primatene Mist is classified as a bronchodilator. It is not a controller or maintenance medication — it provides short-term symptomatic relief only and is not a replacement for long-term asthma management with prescription therapies.
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Primatene Mist contains epinephrine (adrenaline) as its active ingredient. Epinephrine is an alpha and beta adrenergic agonist — meaning it activates both alpha and beta adrenergic receptors throughout the body. When inhaled, it primarily activates beta-2 (β2) adrenergic receptors in the smooth muscle surrounding the bronchial tubes in the lungs.
This beta-2 activation causes the airway smooth muscles to relax and dilate — widening the airways and making it easier to breathe. The effect begins within 3-5 minutes of inhalation and provides meaningful symptom relief within 20 minutes. The duration of effect is approximately 1-4 hours.
Unlike prescription albuterol (a selective beta-2 agonist), epinephrine also activates beta-1 cardiac receptors and alpha-1 vascular receptors. This non-selective mechanism means Primatene Mist can cause greater increases in heart rate and blood pressure compared to more selective bronchodilators, which is why medical guidelines generally prefer prescription albuterol for asthma treatment.
0.125 mg per actuation — Metered-dose inhaler (MDI)
HFA-propelled aerosol; 160 metered sprays per canister (11.7g). For adults and children 12+.
Primatene Mist is widely distributed at major pharmacy chains including CVS, Walgreens, Walmart, Target, Rite Aid, and Kroger, as well as online through Amazon and major pharmacy websites. There is no current FDA-declared national shortage. As an OTC product, it is not tracked by the FDA's Drug Shortage Database.
However, localized stock-outs at individual pharmacies are common — particularly during fall allergy season, winter respiratory illness season, and periods when prescription inhalers face their own supply disruptions. Because Primatene Mist has no generic version and a single manufacturer (Amphastar Pharmaceuticals), stock cannot flex with demand the way multi-source generic products can.
If you're having trouble finding Primatene Mist at your local pharmacy, medfinder can help. medfinder contacts pharmacies near you to check which ones have your medication in stock and texts you the results — saving you the time and frustration of calling pharmacies one by one.
Primatene Mist itself does not require a prescription — it is available over the counter. However, the label requires a physician-confirmed asthma diagnosis before use. If you have not been evaluated for asthma, or if your symptoms are not adequately controlled with Primatene Mist, you should seek evaluation from a healthcare provider. The following types of providers can diagnose asthma and prescribe prescription inhalers:
Primary Care Physicians (PCPs) — family medicine, internal medicine, general practice
Allergists and Immunologists — specialists for allergic asthma and complex cases
Pulmonologists — lung specialists for severe or uncontrolled asthma
Pediatricians — for patients 12 and older (Primatene Mist is not approved for under 12)
Nurse Practitioners (NPs) and Physician Assistants (PAs) — can evaluate and prescribe in most states
Telehealth providers can also evaluate asthma symptoms and prescribe prescription inhalers like albuterol without an in-person visit. Services like Teladoc, MDLive, and GoodRx Care are widely available and can often provide same-day prescriptions.
No. Primatene Mist is not a controlled substance. The Drug Enforcement Administration (DEA) has not assigned it a controlled substance schedule. Epinephrine, the active ingredient in Primatene Mist, is not a scheduled drug under the Controlled Substances Act.
Primatene Mist is available over the counter (OTC) — no prescription is required to purchase it. You can buy it directly from the pharmacy shelf or online at major retailers. However, the product label does require that you have a physician-confirmed diagnosis of asthma before using it. This is a labeling requirement, not a dispensing restriction.
At some pharmacy locations, Primatene Mist may be stocked behind the pharmacy counter as a matter of store policy rather than a regulatory requirement. In those cases, you simply need to ask the pharmacist to retrieve it — no prescription is needed.
The most frequently reported side effects of Primatene Mist (epinephrine inhalation aerosol) include:
Increased heart rate (tachycardia)
Increased blood pressure
Tremors or shakiness
Nervousness or anxiety
Headache
Difficulty sleeping
Dry mouth or throat irritation
Rapid or irregular heartbeat (palpitations)
Chest pain or severe chest tightness
Seizures
Worsening asthma symptoms or no improvement within 20 minutes (seek emergency care)
Need for more than 8 inhalations in 24 hours — see a doctor
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Albuterol (ProAir HFA, Ventolin HFA)
Prescription selective beta-2 SABA; medically preferred for asthma; fewer cardiac side effects; generic available; covered by most insurance
Levalbuterol (Xopenex HFA)
Prescription selective beta-2 SABA; purified form of albuterol; fewer side effects in some patients
Asthmanefrin (racepinephrine)
OTC nebulizer solution; similar mechanism to epinephrine; for ages 4+; requires nebulizer device
Bronkaid (ephedrine/guaifenesin)
OTC oral bronchodilator tablet; behind-the-counter availability; more systemic effects; not recommended as first-line
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MAO Inhibitors (phenelzine, isocarboxazid, tranylcypromine, linezolid)
majorContraindicated. Can cause dangerous hypertensive crisis. Do not use Primatene Mist if you are currently taking or have taken an MAOI within the past 14 days.
Tricyclic Antidepressants (amitriptyline, nortriptyline, imipramine)
majorMay potentiate cardiovascular effects of epinephrine, increasing risk of dangerous arrhythmias or hypertensive events. Use with caution; consult your doctor.
Beta-blockers (propranolol, metoprolol, atenolol)
moderateMay reduce bronchodilator effectiveness of Primatene Mist. Non-selective beta-blockers can worsen asthma in susceptible patients.
Decongestants (phenylephrine, pseudoephedrine, ephedrine)
moderateAdditive stimulant cardiovascular effects. Avoid concurrent use of products containing these ingredients.
Caffeine
minorAdditive stimulant effects. The product label advises avoiding caffeine-containing foods and beverages when using Primatene Mist.
Prescription asthma medications (albuterol, theophylline, others)
moderateConsult your doctor before combining with other asthma medications. Combining bronchodilators may increase cardiovascular side effects.
Primatene Mist plays an important and unique role in US healthcare as the only FDA-approved OTC asthma inhaler. For patients with confirmed mild, intermittent asthma — particularly those with limited access to healthcare or prescription insurance — it provides accessible, immediate bronchodilator relief. It is especially valuable as a backup when prescription inhalers are unavailable or run out.
However, Primatene Mist is not a replacement for comprehensive asthma care. Patients using it more than twice a week, or who have moderate-to-severe asthma, should work with a healthcare provider to establish appropriate prescription therapy. The cardiovascular side effects of epinephrine — increased heart rate and blood pressure — also make it less suitable than prescription albuterol for many patients.
If you're struggling to find Primatene Mist at your local pharmacy, medfinder can help you locate it quickly. medfinder contacts pharmacies near you and texts you which ones have it in stock — saving you time and frustration so you can focus on feeling better.
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