ALE

L-EPINEPHRINE

Created:	1999-07-08
Last modified:	2021-03-01

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Chemical Details
Formal Charge	0
Atom Count	26
Chiral Atom Count	1
Bond Count	26
Aromatic Bond Count	6

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Chemical Component Summary
Name	L-EPINEPHRINE
Synonyms	ADRENALINE
Systematic Name (OpenEye OEToolkits)	4-[(1R)-2-(methylamino)-1-oxidanyl-ethyl]benzene-1,2-diol
Formula	C₉ H₁₃ N O₃
Molecular Weight	183.204
Type	NON-POLYMER

Chemical Descriptors
Type	Program	Version	Descriptor
SMILES	ACDLabs	12.01	Oc1ccc(cc1O)C(O)CNC
SMILES	CACTVS	3.370	CNC[CH](O)c1ccc(O)c(O)c1
SMILES	OpenEye OEToolkits	1.7.6	CNCC(c1ccc(c(c1)O)O)O
Canonical SMILES	CACTVS	3.370	CNC[C@H](O)c1ccc(O)c(O)c1
Canonical SMILES	OpenEye OEToolkits	1.7.6	CNC[C@@H](c1ccc(c(c1)O)O)O
InChI	InChI	1.03	InChI=1S/C9H13NO3/c1-10-5-9(13)6-2-3-7(11)8(12)4-6/h2-4,9-13H,5H2,1H3/t9-/m0/s1
InChIKey	InChI	1.03	UCTWMZQNUQWSLP-VIFPVBQESA-N

Drug Info: DrugBank

DrugBank data are sourced from datasets licensed under a Creative Common's Attribution-NonCommercial 4.0 International License

DrugBank ID	DB00668
Name	Epinephrine
Groups	vet_approved approved
Description	Epinephrine, also known as _adrenaline_, is a hormone and neurotransmitter and produced by the adrenal glands that can also be used as a drug due to its various important functions. Though it has long been used in the treatment of hypersensitivity reactions, epinephrine in the auto-injector form (EpiPen) has been available since 1987 in the USA. Many new products/biosimilars and dosage routes have been approved under various names over the last several decades [L4355], [L4356], [L4358]. On August 16, 2018, Teva Pharmaceuticals USA gained approval to market its generic epinephrine auto-injector in 0.3 mg and 0.15 mg strengths [L4353]. Dosage delivery routes for epinephrine include intravenous, inhalation, nebulization, intramuscular injection, and subcutaneous injection. In general, the most common uses of parenteral epinephrine are to relieve respiratory distress due to bronchospasm, to provide rapid relief of hypersensitivity (anaphylactic or anaphylactoid) reactions to drugs, animal serums and other allergens, and to prolong the action of infiltration anesthetics [F2136]. In addition to the above functions, epinephrine is the primary drug administered during cardiopulmonary resuscitation (CPR) to reverse cardiac arrest [A37697], [A37699]. It can be used in severe cases of croup [L4824].
Synonyms	(R)-(-)-Adnephrine RACEPINEFRINE, (R)- Epinephrin (R)-(-)-Epirenamine 1,2-BENZENEDIOL, 4-(1-HYDROXY-2-(METHYLAMINO)ETHYL)-, (R)- BENZYL ALCOHOL, 3,4-DIHYDROXY-.ALPHA.-((METHYLAMINO)METHYL)-, (-)- (−)-3,4-dihydroxy-α-((methylamino)methyl)benzyl alcohol Epinephrine Epinephrine bitartrate (R)-(−)-adrenaline Adrénaline Epinephrine acetate 4-((1R)-1-HYDROXY-2-(METHYLAMINO)ETHYL)-1,2-BENZENEDIOL (R)-(-)-Epinephrine Epinephrine hydrochloride 4-[(1R)-1-Hydroxy-2-(methylamino)ethyl]-1,2-benzenediol (−)-(R)-epinephrine (−)-adrenaline Epinefrin Epinefrina Adrenaline (R)-(-)-Adrenaline Levoepinephrine L-Adrenaline Epinephrinum
Brand Names	Adyphren Amp II Kit Crown-pak Max 4-ply Lidocaine 2% and Epinephrine 1:100 000 Epinephrine Epinephrine 1:1000 Inj 1mg/ml USP Vivacaine EPY Kit Sensorcaine Mpf Dentsply 2% Lidocaine With Epinephrine 1:100,000 EpiPen Jr Gingi-pak Max Z-twist No 1 Zorcaine Taro-epinephrine Auto-injector Twinject 0.15mg Auto-injector Marcaine Gingi-pak Max Soft-twist No 3 Anapen Junior Epinephrine Inj 0.1mg/ml USP Lidocaine and Epinephrine Inj.usp 2% 1:100000 Twinject Orostat 8% Epinephrinesnap-V Lidocaine Medihaler-Epi Certa Dose Epinephrine Convenience Kit Prilocaine HCl 4% Epineph 1:200000inj Articaine Hydrochloride and Epinephrine Bitartrate Injection E-pilo-1 Oph Soln Xylocaine with epinephrine E-pilo-2 Oph Soln Articadent Bupivacaine Hydrochloride with Epinephrine Epinephrine Injection USP Lidocaine Hydrochloride and Epinephrine Injection USP Epinephrine Pediatrics SENSORCAINE MPF with Epinephrine Dentsply 2% Lidocaine With Epinephrine 1:50,000 Xylocaine 0.5% W Epinephrine 1:200000 Adrenalin Topical Solution Basic Dental Emergency Kit Spinal Anesthesia Tray Lignospan Standard Numbing Hemorrhoidal Label EpinephrineSnap-EMS Pro Numb Adrenalin Leep RediKit Zone 2 Adyphren Kit Xylocaine 2% W Epinephrine 1:200000 Bupivacaine Hydrochloride and Epinephrine Adyphren II Kit EpinephrineSnap-V Ultracaine D-S Injection Adyphren Amp Kit D-Care 100X Dysne Inhal 2% Lidocaine and Epinephrine 1:100,000 Injection USP Lidocaine 2% and Epinephrine 1:50 000 Marcaine E Liq Prt 0.50% Lixtraxen 1% Ultacan Forte Octocaine HCl 2% Epinephrine 1:50000 Prime Asthma Relief Numquick Topical Analgesic Epinephrine 0.3 Adults EPIsnap Epinephrine Convenience Kit Scandonest 2% Special Inj Lidocaine Hydrochloride 1.5% and Epinephrine 1:200000 Injection USP Lidocaine Hydrochloride 1.5% and Epinephrine 1:200000 Injection USP Test Dose Ultracaine DS Inj EpiPen Marcaine E 0.25% Liq Prt Gingi-pak Max Z-twist No 3 Epinephrine Injection USP 1 mg/ml Epinephrine Injection Sensorcaine Xylocaine 1.5% W Epinephrine 1:200000 Xylocaine 1% W Epinephrine 1:200000 Xylocaine 2% W Epinephrine 1:100000 Xylocaine 0.5% W Epinephrine 1:100000 Primatene Mist Refill 4% Citanest Forte Dental With Epinephrine 1:200,000 Bupivacaine HCl 0.5% and Epinephrine 1:200,000 Injection Gingi-pak Max Soft-twist No 1 Septocaine and Epinephrine Ultracaine DS Forte Inj Gingi-pak Max Z-twist No 00 Septanest N Epipen Epinephrine Professional Citanest Forte Xylocaine Dental Lidocaine HCl 2% and Epinephrine 1:100,000 Xylocaine 1.5% W Epinephrine 1:200000 Test Dose Adrenalin(r) Anapen Numquick Analgesic Lignospan Forte Gingi-pak Max 2-ply Xylocaine Minnerva II Neffy E-pilo 2 Ophthalmic Solution Orabloc 1:200,000 4% Astracaine Dental With Epinephrine 1:200,000 (0.005mg/ml) Xylocaine Dental Lidocaine Hydrochloride 2% and Epinephrine 1:50,000 Vasocaine Prilocaine Hydrochloride with Epinephrine Epi E-Z Pen - Liquid - 0.3mg/0.3ml Lidocaine Hci Xylocaine 2% With Epinephrine 1:200000 Taroclick Epinephrine Junior Lidocaine Hydrochloride and Epinephrine Twinject 0.3mg Auto-injector Gingi-pak Cotton Coil Taroclick Epinephrine Articaine Hydrochloride and Epinephrine Epinephrine Convenience Kit Symjepi Ultacan Xylocaine 1% W Epinephrine 1:100000 Xylocaine Mpf 1.5% With Epinephrine The Solution Anorectal Spray Temporary Pain Relief Epipen Jr Adrenalin Vials Xylocaine-mpf With Epi Lidocaine Hci and Epinephrine With Epinephrine Lidocaine Hydrochloride 0.5% and Epinephrine 1:200000 Injection USP Septanest Sp Allerject QKit Procedure Tray Blue Gel Anesthetic Emerade LIDOCAINE HCl AND EPI E-pilo 1 Ophthalmic Solution Marcaine E Articaine The Solution Dentsply 4% Prilocaine and Epinephrine Injection 1:200,000 Deluxe Dental Emergency Kit Auvi-Q Ephinephrine EPY II Kit Articaine HCl and Epinephrine Ana-kit (2mg/tab Orl, 1mg/ml Liq Sc Im) Gold Label Anorectal Numbing Spray Primatene Mist Octocaine HCl 2% Epinephrine 1:100000 Sensorcaine Forte Xylocaine MPF Lidocaine Hydrochloride and Epinephrine Bitartrate Posicaine Sp Octocaine 100 Needleject Inj Gingi-pak Max Soft-twist No 2 Spinal Anaesthesia Tray Epinephrine Chloride Solution Bronkaid Mistometer Aem 0.5% E-pilo-6 Oph Soln Lidocaine Hci and Epinephrine Marcaine 0.5% and Epinephrine 1:200,000 Liq Adrenaclick 0.30mg Auto-injector Anakit Insect Sting Treatment Kit E-pilo 6 Ophthalmic Solution Octocaine 100 Septocaine Gingi Pak Cord No 1 Orabloc 1:100,000 Xylocaine(r) -mpf (lidocaine Hci and Epinephrine) E-pilo 4 Ophthalmic Solution Sensorcaine(r) (bupivacaine Hci and Epinephrine) CLIN-LIDO-Single Use Kit Ana-kit Sensorcaine With Epinephrine Bupivacaine Hci and Epinephrine E-pilo-4 Oph Soln Octocaine 50 Adrenalin (epinephrine in sodium chloride) Adrenalin (epinephrine) Lidocaine 2% and Epinephrine 1:50,000 Gingi-pak Max Z-twist No 2 Lignospan Speciale Inj Adrenaclick LIDOCAINE HCl and EPINEPHRINE Posicaine N LIDOCAINE HCl AND EPINEPHRINE Adrenaclick 0.15mg Auto-injector Marcaine With Epinephrine Orabloc Epinephrine Professional EMS LIDOCAINE HCl Gingi-pak Pellets Lidosite Marcaine with Epinephrine Lidocaine 2% and Epinephrine 1:100,000 4% Astracaine Dental With Epinephrine Forte 1:100,000 (0.01mg/ml) Citanest Forte DENTAL Ultracaine D-S Forte Injection Epinephrine 0.15 Pediatrics
Indication	Epinephrine injection and nasal spray are indicated in the emergency treatment of type I allergic reactions, including anaphylaxis.[L41260, L51798] Epinephrine injection is also used to increase mean arterial blood pressure in adult patients with hypotension associated with septic shock.[L41260] Epinephrine's cardiac effects may be of use in restoring cardiac rhythm in cardiac arrest due to various causes but is not used in cardiac failure or in hemorrhagic, traumatic, or cardiogenic shock [F1247]. Epinephrine is used as a hemostatic agent. It is so used in treating mucosal congestion of hay fever, rhinitis, and acute sinusitis; to relieve bronchial asthmatic paroxysms; in syncope due to complete heart block or carotid sinus hypersensitivity; for symptomatic relief of serum sickness, urticaria, angioneurotic edema; for resuscitation in cardiac arrest following anesthetic accidents; in simple (open-angle) glaucoma; for relaxation of uterine musculature and to inhibit uterine contractions. Epinephrine injection can be utilized to prolong the action of local anesthetics [F1247]. In addition to the above, epinephrine is used as an over the counter (OTC) agent for the intermittent symptoms of asthma, such as wheezing, tightness of chest and shortness of breath [F2131]. It is also used for the maintenance of mydriasis during intraocular surgery [L4825].
Categories	Adrenergic Agents Adrenergic Agonists Adrenergic alpha-1 Receptor Agonists Adrenergic alpha-2 Receptor Agonists Adrenergic alpha-Agonists Adrenergic and Dopaminergic Agents Adrenergic beta-1 Receptor Agonists Adrenergic beta-2 Receptor Agonists Adrenergic beta-3 Receptor Agonists Adrenergic beta-Agonists Adrenergics, Inhalants Agents producing tachycardia Agents that produce hypertension Alpha-and Beta-adrenergic Agonists Amines Anti-Asthmatic Agents Antiglaucoma Preparations and Miotics Autonomic Agents Benzene Derivatives Biogenic Amines Biogenic Monoamines Bronchodilator Agents Cardiac Stimulants Excl. Cardiac Glycosides Cardiac Therapy Cardiovascular Agents Catecholamines Catechols COMT Substrates Cytochrome P-450 CYP2C9 Inhibitors Cytochrome P-450 CYP2C9 Inhibitors (strength unknown) Cytochrome P-450 CYP3A Inhibitors Cytochrome P-450 CYP3A4 Inhibitors Cytochrome P-450 CYP3A4 Inhibitors (strength unknown) Cytochrome P-450 Enzyme Inhibitors Dental Agents Drugs for Obstructive Airway Diseases Epinephrine and similars Hemostatics Hyperglycemia-Associated Agents Local Hemostatics Mydriatics Nasal Preparations Neurotransmitter Agents OCT1 substrates OCT2 Substrates Ophthalmologicals Peripheral Nervous System Agents Phenols Respiratory System Agents Stomatological Preparations Sympathomimetic (Adrenergic) Agents Sympathomimetics Sympathomimetics in Glaucoma Therapy Sympathomimetics, Plain Vasoconstrictor Agents
ATC-Code	A01AD01 R03AK01 B02BC09 C01CA24 S01EA01 R01AA14 R03AA01 S01EA51
CAS number	51-43-4

Drug Targets

DrugBank data are sourced from datasets licensed under a Creative Common's Attribution-NonCommercial 4.0 International License

Name	Target Sequence	Pharmacological Action	Actions
Alpha-1A adrenergic receptor	MVFLSGNASDSSNCTQPPAPVNISKAILLGVILGGLILFGVLGNILVILS...	unknown	agonist
Alpha-1B adrenergic receptor	MNPDLDTGHNTSAPAHWGELKNANFTGPNQTSSNSTLPQLDITRAISVGL...	unknown	agonist
Beta-1 adrenergic receptor	MGAGVLVLGASEPGNLSSAAPLPDGAATAARLLVPASPPASLLPPASESP...	unknown	agonist
Beta-2 adrenergic receptor	MGQPGNGSAFLLAPNGSHAPDHDVTQERDEVWVVGMGIVMSLIVLAIVFG...	unknown	agonist
Alpha-2A adrenergic receptor	MFRQEQPLAEGSFAPMGSLQPDAGNASWNGTEAPGGGARATPYSLQVTLT...	unknown	agonist
Alpha-2B adrenergic receptor	MDHQDPYSVQATAAIAAAITFLILFTIFGNALVILAVLTSRSLRAPQNLF...	unknown	agonist
Alpha-1D adrenergic receptor	MTFRDLLSVSFEGPRPDSSAGGSSAGGGGGSAGGAAPSEGPAVGGVPGGA...	unknown	antagonist
Tumor necrosis factor	MSTESMIRDVELAEEALPKKTGGPQGSRRCLFLSLFSFLIVAGATTLFCL...	unknown	antagonist,agonist
Cytochrome P450 2C9	MDSLVVLVLCLSCLLLLSLWRQSSGRGKLPPGPTPLPVIGNILQIGIKDI...	unknown	inhibitor
Cytochrome P450 3A4	MALIPDLAMETWLLLAVSLVLLYLYGTHSHGLFKKLGIPGPTPLPFLGNI...	unknown	inhibitor
Catechol O-methyltransferase	MPEAPPLLLAAVLLGLVLLVVLLLLLRHWGWGLCLIGWNEFILQPIHNLL...	unknown	substrate
Monoamine oxidase	MENQEKASIAGHMFDVVVIGGGISGLSAAKLLTEYGVSVLVLEARDRVGG...	unknown	substrate
Solute carrier family 22 member 2	MPTTVDDVLEHGGEFHFFQKQMFFLLALLSATFAPIYVGIVFLGFTPDHR...	unknown	substrate
Solute carrier family 22 member 1	MPTVDDILEQVGESGWFQKQAFLILCLLSAAFAPICVGIVFLGFTPDHHC...	unknown	substrate
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Drug Info/Drug Targets: DrugBank 3.0: a comprehensive resource for 'omics' research on drugs. Knox C, Law V, Jewison T, Liu P, Ly S, Frolkis A, Pon A, Banco K, Mak C, Neveu V, Djoumbou Y, Eisner R, Guo AC, Wishart DS. Nucleic Acids Res. 2011 Jan; 39 (Database issue):D1035-41. | PMID:21059682