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)-(−)-adrenaline (−)-3,4-dihydroxy-α-((methylamino)methyl)benzyl alcohol 4-((1R)-1-HYDROXY-2-(METHYLAMINO)ETHYL)-1,2-BENZENEDIOL BENZYL ALCOHOL, 3,4-DIHYDROXY-.ALPHA.-((METHYLAMINO)METHYL)-, (-)- Epinephrine hydrochloride Epinephrine (−)-adrenaline Epinephrin Epinephrine acetate Epinefrin (R)-(-)-Epinephrine (−)-(R)-epinephrine Adrenaline (R)-(-)-Adnephrine Epinephrine bitartrate Epinephrinum Levoepinephrine L-Adrenaline 1,2-BENZENEDIOL, 4-(1-HYDROXY-2-(METHYLAMINO)ETHYL)-, (R)- (R)-(-)-Adrenaline (R)-(-)-Epirenamine Epinefrina Adrénaline RACEPINEFRINE, (R)- 4-[(1R)-1-Hydroxy-2-(methylamino)ethyl]-1,2-benzenediol
Brand Names	Adyphren Amp Kit Adrenalin(r) Xylocaine 1.5% W Epinephrine 1:200000 Lignospan Speciale Inj Octocaine 50 Xylocaine 1% W Epinephrine 1:100000 Xylocaine 2% W Epinephrine 1:100000 Epinephrine Inj 0.1mg/ml USP Neffy Ultacan Forte Orabloc Lignospan Standard Septocaine and Epinephrine Bupivacaine Hydrochloride and Epinephrine Adrenalin (epinephrine) LIDOCAINE HCl AND EPINEPHRINE Ultacan Marcaine E Liq Prt 0.50% Sensorcaine Gingi-pak Max Z-twist No 2 Ana-kit (2mg/tab Orl, 1mg/ml Liq Sc Im) Marcaine Epinephrine Marcaine E 0.25% Liq Prt Septanest N Gingi-pak Max Z-twist No 00 Taroclick Epinephrine Lidocaine Hydrochloride 0.5% and Epinephrine 1:200000 Injection USP Octocaine 100 Leep RediKit Prime Asthma Relief Sensorcaine With Epinephrine Deluxe Dental Emergency Kit Epinephrine Professional Numbing Hemorrhoidal Label Blue Gel Anesthetic Epinephrine Convenience Kit Zone 2 EPIsnap Epinephrine Convenience Kit Marcaine With Epinephrine Xylocaine 2% With Epinephrine 1:200000 Emerade Septocaine Sensorcaine Forte Primatene Mist Xylocaine-mpf With Epi Xylocaine with epinephrine Numquick Analgesic Prilocaine HCl 4% Epineph 1:200000inj Spinal Anesthesia Tray CLIN-LIDO-Single Use Kit EPY Kit Gingi-pak Max Soft-twist No 3 EpinephrineSnap-V Auvi-Q Anakit Insect Sting Treatment Kit Vivacaine Lidosite Marcaine E Numquick Topical Analgesic Orabloc 1:200,000 Twinject 0.15mg Auto-injector Gingi-pak Cotton Coil Xylocaine Dental Lidocaine HCl 2% and Epinephrine 1:100,000 Ana-kit EpiPen Jr The Solution Anorectal Spray Temporary Pain Relief Vasocaine Adrenaclick Octocaine HCl 2% Epinephrine 1:50000 Xylocaine Dental Lidocaine Hydrochloride 2% and Epinephrine 1:50,000 Citanest Forte Symjepi Epinephrine Chloride Solution Lidocaine Hydrochloride and Epinephrine Injection USP Ultracaine D-S Injection Anapen Bupivacaine Hydrochloride with Epinephrine Scandonest 2% Special Inj Lidocaine Hci and Epinephrine Epinephrine Injection Epinephrine Pediatrics Prilocaine Hydrochloride with Epinephrine SENSORCAINE MPF with Epinephrine Citanest Forte DENTAL LIDOCAINE HCl AND EPI Ultracaine DS Forte Inj The Solution Xylocaine Mpf 1.5% With Epinephrine Orostat 8% Adyphren II Kit Epinephrine 0.3 Adults Octocaine HCl 2% Epinephrine 1:100000 Epinephrine Professional EMS Ultracaine DS Inj Xylocaine 1.5% W Epinephrine 1:200000 Test Dose D-Care 100X E-pilo 2 Ophthalmic Solution Posicaine Sp Adrenalin Gingi-pak Max 2-ply Zorcaine Dentsply 4% Prilocaine and Epinephrine Injection 1:200,000 Articaine EpinephrineSnap-EMS Lidocaine 2% and Epinephrine 1:50,000 Xylocaine 2% W Epinephrine 1:200000 Adrenalin Vials Epipen Jr Lidocaine Hydrochloride and Epinephrine Bitartrate Ultracaine D-S Forte Injection Xylocaine(r) -mpf (lidocaine Hci and Epinephrine) Adrenaclick 0.15mg Auto-injector 4% Astracaine Dental With Epinephrine Forte 1:100,000 (0.01mg/ml) Twinject 0.3mg Auto-injector Lignospan Forte Gingi-pak Max Soft-twist No 1 Xylocaine 0.5% W Epinephrine 1:100000 Taro-epinephrine Auto-injector Primatene Mist Refill 2% Lidocaine and Epinephrine 1:100,000 Injection USP Epinephrine Injection USP 1 mg/ml Taroclick Epinephrine Junior Crown-pak Max 4-ply Gold Label Anorectal Numbing Spray 4% Astracaine Dental With Epinephrine 1:200,000 (0.005mg/ml) EPY II Kit Articaine Hydrochloride and Epinephrine Bitartrate Injection Minnerva II Sensorcaine(r) (bupivacaine Hci and Epinephrine) Medihaler-Epi Adrenaclick 0.30mg Auto-injector Certa Dose Epinephrine Convenience Kit Ephinephrine Marcaine with Epinephrine Anapen Junior Articaine HCl and Epinephrine Lidocaine 2% and Epinephrine 1:100,000 4% Citanest Forte Dental With Epinephrine 1:200,000 Allerject Bupivacaine Hci and Epinephrine Xylocaine 0.5% W Epinephrine 1:200000 E-pilo 4 Ophthalmic Solution Adyphren Kit E-pilo-2 Oph Soln Marcaine 0.5% and Epinephrine 1:200,000 Liq Dentsply 2% Lidocaine With Epinephrine 1:50,000 Dysne Inhal Articaine Hydrochloride and Epinephrine Lidocaine Hydrochloride and Epinephrine Xylocaine EpiPen Xylocaine MPF Lidocaine 2% and Epinephrine 1:100 000 Lidocaine and Epinephrine Inj.usp 2% 1:100000 Xylocaine 1% W Epinephrine 1:200000 Bupivacaine HCl 0.5% and Epinephrine 1:200,000 Injection Gingi-pak Max Z-twist No 1 Gingi-pak Max Z-twist No 3 Bronkaid Mistometer Aem 0.5% Sensorcaine Mpf Twinject Lidocaine Hydrochloride 1.5% and Epinephrine 1:200000 Injection USP Pro Numb Epi E-Z Pen - Liquid - 0.3mg/0.3ml Epipen Epinephrine 0.15 Pediatrics Lidocaine LIDOCAINE HCl and EPINEPHRINE Lidocaine Hydrochloride 1.5% and Epinephrine 1:200000 Injection USP Test Dose Epinephrine Injection USP Lixtraxen 1% E-pilo-1 Oph Soln Adrenalin (epinephrine in sodium chloride) Lidocaine 2% and Epinephrine 1:50 000 Lidocaine Hci and Epinephrine With Epinephrine Epinephrinesnap-V Orabloc 1:100,000 Epinephrine 1:1000 Inj 1mg/ml USP Septanest Sp Posicaine N Gingi-pak Max Soft-twist No 2 Octocaine 100 Needleject Inj Dentsply 2% Lidocaine With Epinephrine 1:100,000 Lidocaine Hci LIDOCAINE HCl Gingi-pak Pellets E-pilo 6 Ophthalmic Solution Adrenalin Topical Solution Adyphren Amp II Kit Articadent E-pilo 1 Ophthalmic Solution Basic Dental Emergency Kit Spinal Anaesthesia Tray Gingi Pak Cord No 1 E-pilo-4 Oph Soln E-pilo-6 Oph Soln QKit Procedure Tray
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