Inhaled racepineprhine (RE) became available in September 2012 as a nonprescription treatment for bronchospasm. It is delivered by a handheld electronic nebulizer, its called Asthmanefrin. It is being promoted as a replacement for epinephrine chlorofluoocarbon metered-dose inhaler (Primatene Mist).
Results of a study showed that RE was much less effective than albuterol in protecting against bronchospasm. Many patients self medicate themselves with asthma symptoms and RE that is sold over the counter as Asthmanefrin. A study done at the University of Florida showed that it had some effect but it does not compare to albuterol. Many physicians are against even having this medication OTC. Patients need to see a doctor if they are having respiratory symptoms to assess the best treatment. Many symptoms many not in fact be respiratory related, but it could be cardiac or gastrointestinal as well. An allergist could perform pulmonary function testing or spirometry to get an assessment of the lung function.
Patients should not medicate themselves without consulting a physician first. There has been a strong push to get this medication out of the pharmacy shelves, but it has been unsuccessful. This study shows that even when people treat themselves they are not doing themselves a service, because this medication is sub-par.
Besides taking a detailed history and examination, an allergy doctor can do skin testing to help diagnose potential allergy triggers. If a patient is diagnosed with asthma, their severity needs to be assessed to determine the best asthma treatment. If a patient falls into a persistent category, he/she may need to be on a controller medication. Example are leukotriene antagonists like Singulair, or inhaled corticosteroids, such as Asmanex or Flovent. More severe patients would need to be on a combined inhaled corticosteroid such as Dulera, Symbicort or Advair. More severe patients would be a candidate for Xolair, which is an anti-IgE monoclonal antibody. A physician can help you evaluate your best options.