Can You Use Primatene And Albuterol Together?

In our latest question and answer, the pharmacist discusses if it is safe to use albuterol inhalers with Primatene (inhaled epinephrine).

Question

I wanted to ask if I can take epinephrine intermittently with my albuterol inhaler. I have been experiencing some shortness of breath as a side effect of Wellbutrin. I am on 300 mg. I also take 60 mg of Cymbalta. Sometimes I use Pepcid AC to relieve itchiness. I read that there is an interaction between epinephrine and albuterol. What would you recommend? My psychiatrist was unable to answer. Thank you.

Asked by Fran On May 20, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published May 21, 2022
Last updated May 21, 2022

Key points

  • Inhaled albuterol and epinephrine (the active ingredient in Primatene) work the same way to improve breathing, by stimulating beta-2 receptors. They should not be used at the same time.
  • Using both albuterol and Primatene will increase the risk of side effects, such as increased heart rate, anxiety, and headache.
  • Albuterol and Primatene are short-acting, and the dosing of each could be separated by at least four to six hours.

Hello!

In your question, you mention wanting to know if you can use epinephrine along with your albuterol inhaler, so I am assuming you mean inhaled epinephrine (i.e. epinephrine oral inhalationPrimatene Mist).

You shouldn't be using them at the same time, or within a few hours of each other, as they essentially work the same way to treat asthma symptoms like shortness of breath.

Since inhaled albuterol and epinephrine work the same way, they have similar side effects. Using both together can, therefore, increases the risk of these side effects occurring, and their severity.

How Both Drugs Work To Treat Asthma Symptoms

Both albuterol and epinephrine are classified as 'sympathomimetics'.

While epinephrine (another word for 'adrenalin') has much broader actions overall than albuterol, they both work the same way to help us breathe better and that is by stimulating beta-2 receptors, which are found in the smooth muscle in our airways.

Stimulating beta-2 receptors relaxes smooth muscle, opening our airway, and making it easier to breathe.

Stimulation of these receptors also stops the release of certain molecules from our mast cells (the same cells that release histamine), further decreasing inflammation and airway constriction.

Using albuterol and epinephrine together would really be just using two drugs that work by the same mechanism to treat your shortness of breath.

Side Effects

Since inhaled albuterol and epinephrine work the same way, they will share many of the same side effects.

Using both together, or within a short period of time, can cause:

  • Increased heart rate
  • Nausea
  • Headache
  • Nervousness
  • Anxiety
  • Tremor

If any of these side effects occur, they would be relatively short-lived as both drugs don't last more than a few hours but, again, using albuterol and epinephrine together increases the risk they will happen.

Separating The Drugs

Both drugs are short-acting, but albuterol (the active ingredient in several brand-name inhalers such as Proair, Ventolin, and Proventil) still tends to last longer than inhaled epinephrine (the active ingredient in Primatene).

Each dose of albuterol lasts around 4 to 6 hours while each dose of epinephrine lasts for slightly shorter in most individuals.

Again, they shouldn't be used together, but they could safely be used if you separate dosing by at least 4 to 6 hours.

Final Words

If you find yourself needing to use a short-acting inhaler like albuterol or Primatene often, you should talk to your doctor.

Your asthma may not be well controlled, and other, longer-acting preventative medications are probably better long-term options.

Thanks again for your question!

References

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 11 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Feel free to send him an email at Hello@HelloPharmacist.com! You can also connect with Dr. Brian Staiger on LinkedIn.

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