A large number of asthma cases can be managed with over-the-counter (OTC) medications such as racepinephrine, epinephrine, and ephedrine. But these may not be indicated for everyone with asthma.

Since there is no known cure for asthma, treatment options address symptoms. A variety of prescription medications 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) treatment options such as epinephrine, ephedrine, and racepinephrine.

If you’re thinking about switching to an OTC option, have a discussion with your doctor. They can provide recommendations based on your age, the severity of your symptoms, and your asthma triggers.

This article reviews the different types of OTC asthma treatments that you can discuss with your doctor.

A note about OTC asthma treatment

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

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:

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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 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 asthma cases 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 medication precisely as your doctor has instructed: the correct dose, with the proper technique, at the recommended time.