What OTC Contains Ephedrine? A Guide to Over-the-Counter Ephedrine Products

October 9, 2025 •

3 min read

In the United States, specific over-the-counter (OTC) products containing ephedrine are still available, but their purchase is heavily regulated under federal and state laws. These medications, such as Bronkaid Max and Primatene Tablets, are specifically indicated for the temporary relief of mild, intermittent asthma symptoms.

Quick Summary

Several over-the-counter asthma medications, including Bronkaid Max and Primatene Tablets, contain ephedrine and are sold from behind the pharmacy counter with strict regulations. These oral bronchodilators offer temporary relief of mild, intermittent asthma symptoms but are not suitable for all users.

Key Points

Specific Products: Over-the-counter medications containing ephedrine include Bronkaid Max and Primatene Tablets.
Behind-the-Counter Regulation: Due to federal and state laws, these products are not on store shelves and must be purchased from behind the pharmacy counter.
For Mild Asthma Only: These oral bronchodilators are strictly for the temporary relief of mild, intermittent asthma symptoms, such as wheezing and chest tightness.
Strict Purchase Rules: Buyers must present a valid photo ID and have their information logged into a national database (e.g., NPLEx) to comply with purchase limits.
Safety Precautions Required: Overuse carries serious cardiovascular risks, including high blood pressure, heart attack, and stroke. They should not be used for weight loss or athletic enhancement.
Not for Off-Label Use: The FDA banned ephedrine supplements for weight loss and performance enhancement due to safety concerns.

Current OTC Medications with Ephedrine

While many decongestants no longer contain ephedrine, certain oral bronchodilators for asthma still use it as their active ingredient. These are not available on store shelves and require purchase from behind the pharmacy counter with pharmacist assistance. The main OTC ephedrine products in the U.S. are Bronkaid Max and Primatene Tablets.

Bronkaid Max

Bronkaid Max contains ephedrine sulfate. It is intended for individuals 12 and older to temporarily alleviate mild intermittent asthma symptoms like wheezing, chest tightness, and shortness of breath. The formulation was updated to remove guaifenesin after the Cares Act in 2020.

Primatene Tablets

Primatene Tablets contain ephedrine HCl and also provide temporary relief for mild intermittent asthma symptoms such as wheezing and shortness of breath. This medication helps relax airway muscles to improve airflow and offers flexible dosing.

Important Considerations and Regulations

Due to the potential for diversion in methamphetamine production, OTC ephedrine sales are strictly controlled by federal laws like the Combat Methamphetamine Epidemic Act of 2005 (CMEA) and potentially state laws.

Purchase Restrictions

Behind the Counter: These products are kept behind the pharmacy counter, requiring employee assistance for purchase.
Identification and Logging: Buyers must show a valid photo ID and sign a logbook, which records the transaction and buyer information.
Purchase Limits: Federal law sets daily and monthly limits on the amount of ephedrine a person can buy.
No Direct Access: Customers cannot access these products from store shelves.

Ephedrine vs. Other Decongestants

Ephedrine acts as a bronchodilator, relaxing bronchial smooth muscles to ease breathing in mild asthma. This differs from decongestants like pseudoephedrine and phenylephrine, which primarily reduce congestion by narrowing blood vessels.


Feature	OTC Ephedrine (e.g., Bronkaid Max)	Regulated OTC Pseudoephedrine (e.g., behind-the-counter Sudafed)	Non-Regulated OTC Phenylephrine (e.g., Sudafed PE)
Primary Use	Temporary relief of mild, intermittent asthma symptoms (wheezing, shortness of breath)	Temporary relief of nasal congestion	Temporary relief of nasal congestion
Mechanism	Bronchodilator	Vasoconstrictor	Vasoconstrictor
Location	Behind the pharmacy counter	Behind the pharmacy counter	On the store shelf
Purchase Requirements	Photo ID, logbook, purchase limits	Photo ID, logbook, purchase limits	No restrictions
Primary Target Organ	Lungs (bronchial airways)	Nasal passages (sinuses)	Nasal passages (sinuses)

Safe Use of OTC Ephedrine

Using OTC ephedrine products according to the Drug Facts label is crucial. They are only for individuals with a confirmed asthma diagnosis.

Warnings and Risks

Cardiovascular Effects: Ephedrine can raise blood pressure and heart rate, increasing the risk of heart attack or stroke, especially with higher doses or other stimulants.
Drug Interactions: Do not use with MAOIs or within 14 days of stopping one. Avoid other stimulants like caffeine.
Not for Off-Label Use: The FDA prohibits ephedrine use in weight loss or performance supplements due to serious risks. These OTC products are not safe or approved for such uses.

When to Consult a Healthcare Provider

Seek medical help if:

Asthma symptoms worsen or don't improve.
Experiencing difficulty sleeping, rapid heart rate, tremors, or nervousness.
Having a history of heart issues, high blood pressure, diabetes, thyroid problems, or other chronic conditions.
Needing the medication more often than directed.

Conclusion

In the U.S., only specific OTC products like Bronkaid Max and Primatene Tablets contain ephedrine for temporary relief of mild, intermittent asthma symptoms. These medications are strictly regulated and sold behind the pharmacy counter to prevent misuse. Buyers must show ID, follow purchase limits, and use them only as directed after an asthma diagnosis. The regulations ensure careful use and highlight the medicinal purpose while reducing diversion risks. Consult a pharmacist or healthcare provider for safe use.

Visit the official DEA Diversion Control website for more information on the Combat Methamphetamine Epidemic Act of 2005.

Frequently Asked Questions

The primary medical use of OTC ephedrine products, such as Bronkaid Max and Primatene Tablets, is for the temporary relief of mild symptoms of intermittent asthma, including wheezing, chest tightness, and shortness of breath.

OTC ephedrine products are kept behind the pharmacy counter to prevent their diversion for the illegal production of methamphetamine, as mandated by the Combat Methamphetamine Epidemic Act of 2005 (CMEA).

To purchase an OTC ephedrine product, you must present a valid, government-issued photo ID and provide your signature, as the transaction is logged into a national tracking system.

No, the FDA has banned ephedrine-containing dietary supplements for weight loss or athletic performance due to safety risks, including heart attack and stroke. These OTC products are only approved for mild, intermittent asthma.

Ephedrine is a bronchodilator for asthma, while pseudoephedrine is a nasal decongestant. Both are structurally similar and regulated due to their potential use in methamphetamine synthesis, but they are distinct substances with different primary medical uses.

Common side effects of ephedrine include an increase in blood pressure and heart rate, as well as insomnia, nervousness, and tremors.

Individuals with heart disease, high blood pressure, or thyroid disease should consult a doctor before use.