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