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Epinephrine

Intravenous
Subcutaneous
Intramuscular
Intranasal
Inhalation
Intracardiac
Class
Adrenal hormones
Subclass
Catecholamines
Generic name
EPINEPHrine, adrenaline
Brand names
Auvi-Q®
Common formulations
Solution for injection
Dosage and administration
Adults patients
Treatment of CCB toxicityOff-label
Start at: 8-12 mcg/min IV continuous infusion
Maintenance: up to 150 mcg/min IV continuous infusion
Titrate based on response to maintain mean arterial pressure of 65 mmHg.
Indications for use
Labeled indications
Adults
Treatment of anaphylaxis
Treatment of hypotension (septic shock)
Off-label indications
Adults
Treatment of CCB toxicity
Safety risks
Contraindications
In the presence of cardiac dilatation or coronary insufficiency
Organic brain syndrome or cerebrovascular disease
Shock during general anesthesia with halogenated hydrocarbons or cyclopropane, and in individuals with organic brain damage
Warnings and precautions
Arrhythmias, myocardial infarction
Use caution in patients with heart disease, including cardiac arrhythmias, coronary artery disease, or hypertension or elderly patients and pregnant women.
Cardiac arrhythmias
Use extreme caution in patients with coronary artery disease.
Use extreme caution in patients with hypertension.
Cerebrovascular accident
Maintain a high level of suspicion to prevent overdosage or inadvertent I.V. injection of epinephrine as, it may cause cerebrovascular hemorrhage resulting from the sharp rise in the BP.
Exacerbation of Parkinson's disease
Use caution in patients with Parkinson's disease.
Exacerbation of thyroid disease
Use caution in patients with hyperthyroidism or thyrotoxicosis.
Hyperglycemia
Use caution in patients diabetes mellitus.
Hypertensive crisis
Use caution in patients with pheochromocytoma.
Specific populations
Renal impairment
eGFR 0-90 mL/min/1.73 m²
Use acceptable. No dose adjustment required.
Renal replacement therapy
Any modality
Use acceptable. No dose adjustment required.
Hepatic impairment
Any severity
Use acceptable. No dose adjustment required.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: A
Use only if benefits outweigh potential risks. Evidence of fetal harm in animals. There are no adequate and well-controlled studies in pregnant women. Epinephrine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus (fetal anoxia, spontaneous abortion, or both).
Breastfeeding
Little information available on breastfeeding safety.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Common 1-10%
Pallor, anxiety, anxiety, dizziness, headache, nausea, vomiting, palpitations, restlessness, sweating, weakness, tremor
Uncommon < 1%
Disorientation, hypertension, ↑ blood glucose, necrotizing fasciitis, panic attack-type symptoms, premature ventricular contractions, angina pectoris, arrhythmia, memory impairment, tachycardia, takotsubo cardiomyopathy
Unknown frequency
Pallor, tachycardia, angina pectoris, dyspnea, anxiety, dizziness, skin flushing, headache, nausea, nervousness, palpitations, restlessness, sweating, tremor, vomiting, weakness
Interactions
Drug(s)
Check Interactions
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