I Don't Have My Albuterol. Can I Use Primatene Instead?

Quick Answer

Primatene, which contains epinephrine, can be helpful as an albuterol alternative if you are having problems getting your albuterol filled, and you are having an asthma attack. However, there are risks associated with using Primatene and it is extremely important you work on trying to continue getting your albuterol inhaler filled so you can have it handy when you need it.

If you have both on hand (Primatene & albuterol), they shouldn't be used together (we wrote a detailed answer on this topic which can be found on our website).

Detailed Answer

Firstly, it's essential to follow up with your pharmacy regarding the status of your Albuterol inhaler.

You mentioned that it is not ready yet, but I urge you to find out why to see what interventions you can make. It's an important medication to have on hand should you need it (such as when you're having a flare-up as you mentioned in your question).

What is the reason for the delay? Are there no refills? Is there a supply problem? Is the pharmacy too busy? Is it an insurance issue?

It's important to understand when you can expect the inhaler to be ready and why it isn't yet. Additionally, it's worth discussing with your doctor the possibility of getting a spare inhaler if you have not yet done so.

Many doctors allow their patients to have an extra inhaler and write prescriptions in a way to allow it. For example, it's extremely common that children are dispensed two at a time, one for home and one for school. If insurance doesn't cover two, it may be worthwhile to pay for one out of pocket.

Regarding the use of an epinephrine inhaler, also known as Primatene, to alleviate asthma symptoms, yes, it certainly can be helpful for alleviating breathing problems, especially if you are having an asthma attack. Like albuterol, it helps to open your airways.

However, it's essential to understand the potential risks involved.

The FDA has issued a warning about multiple adverse events associated with these products, including symptoms such as chest pain, nausea, vomiting, increased blood pressure, increased heart rate, and hemoptysis (coughing up blood). Epinephrine is typically associated with more side effects than albuterol.

How Primatene & Albuterol Are Different

Albuterol and epinephrine inhalers, like Primatene, are both medications used to open the airways and relieve symptoms of asthma and other respiratory conditions. However, they differ in their mechanism of action and how they interact with different receptors in the body.

Albuterol is a selective beta-2 adrenergic receptor agonist. It works by binding to the beta-2 adrenergic receptors on the smooth muscle cells in the airways, which results in the relaxation of the muscles and the opening of the airways. This leads to improved airflow and relief of symptoms such as shortness of breath, wheezing, and coughing.

In contrast, epinephrine acts on both the beta-1 and beta-2 adrenergic receptors in the body (i.e., it is a non-selective beta receptor agonist). This means that it has a broader range of effects and can cause stimulation of both heart and lung tissue (where some beta-1 receptors reside).

The activation of beta-1 receptors can lead to an increase in heart rate, cardiac output, and blood pressure (which can lead to other effects, like tremors), while the activation of beta-2 receptors can lead to the relaxation of the smooth muscle cells in the airways and the opening of the airways. So, this means that while epinephrine can be effective in opening the airways, it carries a higher risk of side effects compared to selective beta-2 adrenergic receptor agonists like albuterol.

Additionally, the non-selective action of epinephrine means that it has a lower potency in opening the airways compared to selective beta-2 agonists like albuterol. 

As such, the use of epinephrine inhalers is generally not recommended for long-term asthma management, and they are typically used as a short-term rescue option for individuals who do not have access to more effective inhalers.

Options

As mentioned, if there are no other options available, Primatene can certainly be used to help with breathing. It is effective and the priority in treating an asthma attack is to open your airways, and Primatene will do just that.

Still, it's just as important to obtain the prescribed albuterol inhaler as soon as possible.

If you happen to have both inhalers on hand, it's not recommended to use both inhalers together, as this can increase the risk of side effects (see our article on the matter). However, after 3-4 hours, the effects of both of these medications will have worn off. Just don't use them together within this window.

In the meantime, you should follow any other asthma management strategies your doctor has provided, such as avoiding triggers and taking any other medications as directed.

Final Words

In conclusion, while waiting for your prescribed albuterol inhaler, it's essential to understand the potential risks involved with using over-the-counter epinephrine inhalers, such as Primatene. Nevertheless, if you are having an asthma attack, it is certainly better than nothing and will help your breath better.

I hope you found this helpful and please feel free to reach back out anytime.