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].
4% Citanest Forte Dental With Epinephrine 1:200,000
Xylocaine(r) -mpf (lidocaine Hci and Epinephrine)
Gingi-pak Max Soft-twist No 3
EpinephrineSnap-V
Gingi-pak Pellets
Octocaine HCl 2% Epinephrine 1:100000
Twinject 0.3mg Auto-injector
Epinephrinesnap-V
Dysne Inhal
Septocaine and Epinephrine
Taroclick Epinephrine
Ultracaine D-S Forte Injection
Marcaine E
EPY Kit
Articaine Hydrochloride and Epinephrine
Spinal Anesthesia Tray
Dentsply 4% Prilocaine and Epinephrine Injection 1:200,000
Gingi-pak Max Z-twist No 00
Emerade
EpinephrineSnap-EMS
Marcaine 0.5% and Epinephrine 1:200,000 Liq
Prilocaine Hydrochloride with Epinephrine
EPIsnap Epinephrine Convenience Kit
Posicaine Sp
E-pilo-1 Oph Soln
Gingi-pak Cotton Coil
Articaine
Lidocaine
EPY II Kit
Xylocaine 2% W Epinephrine 1:100000
Lignospan Forte
Sensorcaine With Epinephrine
Bronkaid Mistometer Aem 0.5%
Gingi Pak Cord No 1
Epinephrine 1:1000 Inj 1mg/ml USP
Prime Asthma Relief
Adrenalin Chloride Sol 1:1000 Amp
E-pilo-6 Oph Soln
Sensorcaine
Gingi-pak Max 2-ply
Xylocaine 0.5% W Epinephrine 1:200000
Adrenalin(r)
Ultracaine D-S Injection
Ultracaine DS Inj
Lidocaine Hydrochloride 0.5% and Epinephrine 1:200000 Injection USP
Lignospan Standard
Epinephrine Inj 0.1mg/ml USP
Adyphren Amp II Kit
Marcaine with Epinephrine
Octocaine 100
Xylocaine MPF
Gingi-pak Max Soft-twist No 2
Lidosite
Sensorcaine Mpf
EpiPen Jr
Gingi-pak Max Z-twist No 2
Epinephrine Professional EMS
Orabloc 1:200,000
Numbing Hemorrhoidal Label
Posicaine N
Adrenalin
Twinject
Numquick Analgesic
SENSORCAINE MPF with Epinephrine
Auvi-Q
Lidocaine 2% and Epinephrine 1:50 000
Lidocaine Hydrochloride and Epinephrine Injection USP
Lidocaine Hydrochloride and Epinephrine Bitartrate
Xylocaine 2% With Epinephrine 1:200000
Anapen
Ana-kit (2mg/tab Orl, 1mg/ml Liq Sc Im)
Xylocaine 1.5% W Epinephrine 1:200000 Test Dose
Lignospan Speciale Inj
Vasocaine
Lidocaine Hydrochloride 1.5% and Epinephrine 1:200000 Injection USP Test Dose
Orostat 8%
Adrenaclick 0.30mg Auto-injector
Xylocaine with epinephrine
Certa Dose Epinephrine Convenience Kit
CLIN-LIDO-Single Use Kit
Lidocaine Hydrochloride 1.5% and Epinephrine 1:200000 Injection USP
Octocaine HCl 2% Epinephrine 1:50000
Citanest Forte
Septanest N
Ephinephrine
Epipen Jr
Bupivacaine Hci and Epinephrine
Citanest Forte DENTAL
Lidocaine Hci and Epinephrine
Xylocaine 2% W Epinephrine 1:200000
Xylocaine Dental Lidocaine HCl 2% and Epinephrine 1:100,000
Xylocaine 1% W Epinephrine 1:200000
Articadent
Sensorcaine(r) (bupivacaine Hci and Epinephrine)
Leep RediKit
Adrenalin (epinephrine)
Ana-kit
Lidocaine Hci and Epinephrine With Epinephrine
Articaine Hydrochloride and Epinephrine Bitartrate Injection
Xylocaine Mpf 1.5% With Epinephrine
Allerject
Anakit Insect Sting Treatment Kit
Adyphren Amp Kit
Epinephrine
Lidocaine 2% and Epinephrine 1:100 000
Taro-epinephrine Auto-injector
Octocaine 100 Needleject Inj
Adyphren Kit
E-pilo 4 Ophthalmic Solution
Lixtraxen 1%
Sensorcaine Forte
Xylocaine Dental Lidocaine Hydrochloride 2% and Epinephrine 1:50,000
Bupivacaine Hydrochloride with Epinephrine
4% Astracaine Dental With Epinephrine 1:200,000 (0.005mg/ml)
Octocaine 50
Xylocaine 1.5% W Epinephrine 1:200000
Medihaler-Epi
Marcaine With Epinephrine
Epinephrine Injection USP 1 mg/ml
Adrenaclick 0.15mg Auto-injector
Lidocaine Hydrochloride and Epinephrine
Lidocaine and Epinephrine Inj.usp 2% 1:100000
Primatene Mist
Adrenalin Chloride Sol 1:1000
Bupivacaine Hydrochloride and Epinephrine
Lidocaine 2% and Epinephrine 1:50,000
Numquick Topical Analgesic
Symjepi
LIDOCAINE HCl
Spinal Anaesthesia Tray
Xylocaine 0.5% W Epinephrine 1:100000
Gingi-pak Max Z-twist No 3
2% Lidocaine and Epinephrine 1:100,000 Injection USP
Lidocaine Hci
Anapen Junior
Epinephrine Professional
4% Astracaine Dental With Epinephrine Forte 1:100,000 (0.01mg/ml)
Ultracaine DS Forte Inj
Orabloc 1:100,000
Twinject 0.15mg Auto-injector
Dentsply 2% Lidocaine With Epinephrine 1:50,000
Epinephrine Injection USP
Articaine HCl and Epinephrine
Gingi-pak Max Soft-twist No 1
LIDOCAINE HCl AND EPINEPHRINE
Ultacan
Orabloc
Epipen
Septanest Sp
Lidocaine 2% and Epinephrine 1:100,000
E-pilo 1 Ophthalmic Solution
Septocaine
Epinephrine Convenience Kit
E-pilo 6 Ophthalmic Solution
QKit Procedure Tray
Bupivacaine HCl 0.5% and Epinephrine 1:200,000 Injection
Taroclick Epinephrine Junior
E-pilo-2 Oph Soln
Scandonest 2% Special Inj
Gingi-pak Max Z-twist No 1
Adyphren II Kit
Marcaine E 0.25% Liq Prt
Zorcaine
Indication
Epinephrine injection is indicated in the emergency treatment of allergic reactions (Type I) including anaphylaxis to stinging insects (e.g., order Hymenoptera, which include bees, wasps, hornets, yellow jackets and fire ants) and biting insects (e.g., triatoma, mosquitos), allergen immunotherapy, foods, drugs, diagnostic testing substances (e.g., radiocontrast media) and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis. Injectable epinephrine is intended for immediate/urgent administration in patients, who are found to be at increased risk for anaphylaxis, including individuals with a history of anaphylaxis. Selection of the appropriate dosage strength is determined according to body weight [FDA label]. 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 also 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].
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
