Class Name(s):

• 12:12.12 alpha- and beta-Adrenergic Agonists

Pronunciation:

• (ep'' i nef' rin)

Brand Name(s):

• Primatene Mist^®

WHY is this medicine prescribed?

Epinephrine oral inhalation is used to relieve symptoms of asthma that occur from time to time, including wheezing, chest tightness, and shortness of breath in adults and children 12 years of age and older. Epinephrine oral inhalation is in a class of medications called alpha- and beta-adrenergic agonists (sympathomimetic agents). It works by relaxing and opening air passages to the lungs to make breathing easier.

HOW should this medicine be used?

Epinephrine oral inhalation comes as an aerosol (liquid) to inhale by mouth. It is used as needed to control your asthma symptoms. Follow the directions on the product label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use epinephrine oral inhalation exactly as directed. Do not use more or less of it or use it more often than directed.

Epinephrine oral inhalation is available without a prescription (over the counter). This medication should only be used if a doctor has told you that you have asthma.

If your symptoms do not improve within 20 minutes of use, if your asthma becomes worse, if you need more than 8 inhalations in a 24-hour period, or if you have more than 2 asthma attacks in a week, see a doctor right away. These may be signs that your asthma is getting worse and that you need a different treatment.

To inhale the aerosol using an inhaler, follow these steps:

1. Remove the cap.
2. If you are using the inhaler for the first time, you will need to prime it. To prime the inhaler, shake it well and then press down on the canister to release a spray into the air, away from your face. Repeat this for a total of 4 times (e.g., shake and then spray).
3. Every time you use your inhaler after the first time, shake it and then spray into the air 1 time before each use.
4. When you are ready to use the medication, place inhaler in mouth; inhale deeply while pressing down on top of inhaler and continue the breath as long as possible.
5. Exhale and wait 1 minute.
6. If your symptoms do not improve, use a second inhalation by repeating steps 3-5.
7. If you have used up to 2 sprays (1 dose); wait at least 4 hours between another dose. Do not use more than 8 inhalations in 24 hours.
8. Clean your inhaler daily after use by running water through the mouthpiece for 30 seconds. Follow the manufacturer's directions carefully and ask your doctor or pharmacist if you have any questions about cleaning your inhaler.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Are there OTHER USES for this medication?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before using epinephrine oral inhalation,

• tell your doctor and pharmacist if you are allergic to epinephrine, any other medications, or any of the ingredients in epinephrine oral inhalation. Ask your pharmacist for a list of the ingredients.
• tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past two weeks: isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam),
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, dietary or nutritional supplements, you are taking or plan to take. Be sure to mention any of the following: other asthma medications; caffeine; medications for depression, psychiatric, or emotional conditions; medications for obesity or weight control; phenylephrine (Sudafed PE); or pseudoephedrine (Sudafed, in Clarinex-D).
• the following nonprescription or herbal products may interact with epinephrine oral inhalation: phenylephrine (Sufafed PE), pseudoephedrine (Sudafed, in Clarinex-D); herbal products you are taking for tiredness or to increase energy. Be sure to let your doctor and pharmacist know that you are taking these medications before you start using epinephrine oral inhalation. Do not start any of these medications while using epinephrine oral inhalation without discussing with your healthcare provider.
• tell your doctor if you have ever been hospitalized for treatment of asthma. Also, tell your doctor if you have or have ever had high blood pressure, diabetes, difficulty urinating due to an enlarged prostate, seizures, narrow angle glaucoma (a serious eye condition that may cause loss of vision), or thyroid or heart disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using epinephrine oral inhalation, call your doctor.

What SPECIAL DIETARY instructions should I follow?

Talk to your doctor about drinking or eating caffeine-containing beverages or foods while using this medicine.

What SIDE EFFECTS can this medicine cause?

Some side effects can be serious. If you experience any of these symptoms, stop using your inhaler and call your doctor immediately:

• fast, pounding, or irregular heartbeat
• tremors
• nervousness
• seizure
• difficulty fallling asleep or staying asleep

Epinephrine oral inhalation may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at http://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat (>120° F [49° C] and open flame. Do not puncture or incinerate the container.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website http://goo.gl/c4Rm4p for more information.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor.

Ask your pharmacist any questions you have about epinephrine oral inhalation.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™ Copyright, 2025. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: January 15, 2019.