Epinephrine


Full Generic Medicine Info
Dosage/Direction for Use

Inhalation
Acute asthma
Adult: Spray: Aqueous solution with an adrenaline content equivalent to 1:100. Pressurised aerosols delivering metered doses equivalent to approximately 160-275 mcg: 1-2 inhalations, may repeat after 3 hr if necessary.

Parenteral
Acute asthma
Adult: As 1:1,000 aqueous solution: 0.3-0.5 ml (300-500 mcg). Dose may be given via IM or SC inj.
Child: As 1:1,000 aqueous solution: 0.01 ml/kg (10 mcg/kg). Max: 0.5 ml (500 mcg). Dose may be given via IM or SC inj.

Intravenous
Advanced cardiac life support
Adult: Initially, 1 mg (10 mL of a 1:10,000 solution), may repeat as often as every 3-5 minutes throughout the resuscitation process. May also be given via intraosseous route at the same dosage. For endotracheal doses: 2-2.5 mg every 3-5 minutes.
Child: Initially, 10 mcg/kg, max single dose 1mg, may repeat as often as every 3-5 minutes throughout the resuscitation process via IV or Intraosseous. Endotracheal doses: 100 mcg/kg. Max single dose 2.5 mg.
Max Dosage: Intraosseous doses for adults and children are the same as IV doses.

Intravenous
Anaphylactic shock
Adult: 0.5 mg (5 mL of a 1:10,000 solution) given at a slow rate of 100 mcg/minute, stopping when a response is achieved.
Child: 10 mcg/kg. If autoinjectors are used, doses are based on body wt: 15-30 kg: 150 mcg and >30 kg: 300 mcg.

Intramuscular
Anaphylactic shock
Adult: As 1:1,000 solution: 500 mcg (0.5 ml), repeat every 5 minutes as needed until improvement occurs. For emergency self-admin (e.g. via autoinjector): A dose of 300 mcg (0.3 ml) may be used.
Child: Dose depends on age and weight. Usual dose: 10 mcg/kg.

Ophthalmic
Open-angle glaucoma
Adult: Instill 0.5%, 1% or 2% eye drops once or twice daily.

Ophthalmic
Ocular hypertension
Adult: Instill 0.5%, 1% or 2% eye drops once or twice daily.
Contraindications
Preexisting hypertension; occlusive vascular disease; angle-closure glaucoma (eye drops); hypersensitivity; cardiac arrhythmias or tachycardia. When used in addition to local anaesthetics: Procedures involving digits, ears, nose, penis or scrotum.
Special Precautions
CV diseases; hyperthyroidism; DM; Parkinson's disease; elderly; pregnancy, lactation.
Adverse Reactions
CNS effects; GI disturbances; epigastric pain; CV disorders; difficulty in micturition with urinary retention; dyspnoea; hyperglycaemia; sweating; hypersalivation; weakness, tremors; coldness of extremities; hypokalaemia. Gangrene, tissue necrosis and sloughing (extravasation) when used in addition to local anaesthetics. Eye drops: Severe smarting, blurred vision, photophobia; naso-lachrymal ducts obstruction. Oedema, hyperaemia and inflammation of the eyes with repeated administration.
Overdosage
Overdosage intravascular inj of epinephrine may cause cerebral haemorrhage due to a sharp rise in BP. Fatalities may also result from pulmonary oedema because of peripheral vascular constriction together with cardiac stimulation.
Drug Interactions
Halogenated inhalation anaesthetics; β- or α-blocking agents; methyldopa, guanethidine; drugs with vasoconstrictor and pressor effects; antihypertensives; adrenergic neuron blockers; potassium-depleting drugs; cardiac glycosides; ephedra, yohimbe. TCAs may induce hypertension and arrhythmia.
Lab Interference
Increase in bilirubin, catecholamines, glucose, uric acid.
Action
Epinephrine, an active principle of the adrenal medulla, is a direct-acting sympathomimetic. It stimulates α- and β-adrenergic receptors resulting in relaxation of smooth muscle of the bronchial tree, cardiac stimulation and dilation of skeletal muscle vasculature. It is frequently added to local anaesthetics to retard diffusion and limit absorption, to prolong the duration of effect and to lessen the danger of toxicity.
Onset: SC: approx 5-10 min; inhalation: approx 1 min; conjunctival instillation: IOP declines approx 1 hr.
Duration: Ocular effect: 12-24 hrs.
Storage
Inhalation: Store at 25°C. Intramuscular: Store at 25°C. Intravenous: Store at 25°C. Ophthalmic: Store at 25°C. Parenteral: Store at 25°C.
CIMS Class
Antiasthmatic & COPD Preparations / Antiglaucoma Preparations / Cardiac Drugs
ATC Classification
B02BC09 - epinephrine ; Belongs to the class of local hemostatics. Used in the treatment of hemorrhage.
A01AD01 - epinephrine ; Belongs to the class of other agents for local oral treatment.
R03AA01 - epinephrine ; Belongs to the class of adrenergic inhalants, alpha- and beta-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
C01CA24 - epinephrine ; Belongs to the class of adrenergic and dopaminergic cardiac stimulants excluding glycosides. Used in the treatment of heart failure.
S01EA01 - epinephrine ; Belongs to the class of sympathomimetics used in the treatment of glaucoma.
R01AA14 - epinephrine ; Belongs to the class of topical sympathomimetic agents used as nasal decongestants.
Disclaimer: This information is independently developed by CIMS based on epinephrine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
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