Side effect of epinephrine

Epinephrine

Epinephrine is a naturally occurring hormone and a neurotransmitter that’s also known as adrenaline.

As an injectable medicine, such as EpiPen or Adrenaclick, epinephrine is used to treat life-threatening allergic reactions (anaphylaxis) caused by foods, insect bites, and other allergens.

EpiPen and Adrenaclick are pre-filled auto-injectors that deliver the drug under the skin or into the muscles of the outer thigh.

Epinephrine is also used in emergencies known as asystole, during which the heart stops beating, and to treat exercise-induced anaphylaxis.

The drug is in a class of medicines called vasopressors. It works by relaxing airway muscles and tightening blood vessels.

An injection of epinephrine quickly improves breathing, stimulates the heart, raises dropping blood pressure, reverses hives, and reduces swelling of the face, lips, and throat.

Epinephrine Warnings

Epinephrine can help treat a serious allergic reaction, but it doesn’t take the place of medical care.

You should seek emergency medical treatment immediately after you inject the medication.

Tell your doctor if you have ever had:

  • Chest pain (angina)
  • Irregular heartbeat (arrhythmia)
  • High blood pressure
  • Heart disease
  • Overactive thyroid (hyperthyroidism) or any thyroid disorder
  • Asthma
  • Diabetes
  • Parkinson’s disease
  • Depression or another mental illness

If you use an auto-injector such as EpiPen, tell your doctor if you have arthritis or difficulty using your hands.

Also tell your doctor if you are taking a monoamine oxidase inhibitor (MAOI), such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped taking one within the past two weeks.

Elderly patients may be more sensitive to the effects of epinephrine.

These patients must monitor their symptoms and responses to the drug carefully.

Epinephrine may make you dizzy.

You should not drive, operate machinery, or perform any activity that requires alertness until you are certain you can do so safely.

Keep your EpiPen auto-injector with you at all times, so you can use it as soon as you experience signs of a serious allergic reaction.

Talk to your doctor about the signs and symptoms of a reaction, which may include:

  • Wheezing or difficulty breathing
  • Closing of the airways
  • Sneezing
  • Hoarseness
  • Hives
  • Itching
  • Swelling of the face, eyes, or tongue
  • Redness of the skin
  • Fast heartbeat
  • Weak pulse
  • Anxiety
  • Confusion
  • Stomach pain or vomiting
  • Losing of bowel control or diarrhea
  • Dizziness, faintness, or loss of consciousness

When using the injection device, don’t put your thumb, fingers, or hand over the needle area.

If you accidentally inject epinephrine into your fingers, hands, toes, or feet, seek emergency medical treatment immediately.

Be aware of the expiration date stamped on your auto-injector, and replace the device when appropriate.

Look at the solution in the device, too: If it’s discolored or contains particles, tell your doctor, so you can get a new one.

Do not refrigerate this medication or leave it in your car, especially during cold or hot weather.

If you drop the auto-injector, check to see if it’s broken or leaking.

Pregnancy and Epinephrine

Epinephrine might cause harm to an unborn baby.

It’s not known whether epinephrine passes into breast milk or could harm a breastfeeding baby.

Tell your doctor if you are pregnant, might become pregnant, or are breastfeeding before using epinephrine.

Teva Announces Availability of a Generic Equivalent of EpiPen Jr® (epinephrine injection, USP) Auto-Injector, 0.15 mg in the United States

JERUSALEM & PARSIPPANY, N.J.–(BUSINESS WIRE)– Teva Pharmaceutical Industries (NYSE and TASE: TEVA) today announced availability of the FDA-approved generic version of EpiPen Jr®1 (epinephrine injection, USP) Auto-Injector, 0.15 mg, in the U.S. The product is available in most retail pharmacies, and the Wholesale Acquisition Cost is $3002 for a 2-pack.

”We’re pleased to provide access to Epinephrine Injection (Auto-Injector) in two strengths for patients who may experience life-threatening allergic emergencies,” said Brendan O’Grady, EVP and Head of North America Commercial. “We will continue working to ensure availability of both strengths in the US and plan to accelerate production to meet the urgent need for this medicine.”

With nearly 500 generic medicines available, Teva has the largest portfolio of FDA-approved generic products on the market and holds the leading position in first-to-file opportunities, with over 100 pending first-to-files in the US. Currently, one in nine generic prescriptions dispensed in the US is filled with a Teva product.

Teva’s generic equivalent of EpiPen® and EpiPen Jr® utilize the Antares Pharma (NASDAQ: ATRS) VIBEX® device. Antares and Teva have an exclusive License, Development and Supply Agreement for epinephrine auto injector products that Teva markets in the U.S.

About Epinephrine Injection

Epinephrine Injection (Auto-Injector) is a prescription medicine in a disposable, prefilled automatic injection device (auto-injector) used to treat life-threatening, allergic emergencies including anaphylaxis in people who are at risk for or have a history of serious allergic emergencies. Each device contains a single dose of epinephrine.

Epinephrine Injection (Auto-Injector) is for immediate self (or caregiver) administration and does not take the place of emergency medical care. You should get emergency help right away after using Epinephrine Injection (Auto-Injector).

Epinephrine Injection, 0.3 mg (Auto-Injector) is for patients who weigh 66 pounds or more (30 kilograms or more). Epinephrine Injection, 0.15 mg (Auto-Injector) is for patients who weigh about 33 to 66 pounds (15 to 30 kilograms). It is not known if Epinephrine Injection (Auto-Injector) is safe and effective in children who weigh less than 33 pounds (15 kilograms).

IMPORTANT SAFETY INFORMATION

Anaphylaxis can be life-threatening, can happen within minutes, and can be caused by stinging and biting insects, allergy injections, foods, medicines, exercise, or unknown causes. Use Epinephrine Injection (Auto-Injector) right away when you have an allergic emergency (anaphylaxis). Get emergency medical help right away. You may need further medical attention. You may need to use a second Epinephrine Injection (Auto-Injector) if symptoms continue or recur. Only a healthcare provider should give additional doses of epinephrine if you need more than 2 injections for a single anaphylaxis episode.

Epinephrine Injection (Auto-Injector) should only be injected into the middle of your outer thigh (upper leg) through clothing if necessary. Do not inject the Epinephrine Injection (Auto-Injector) into your: veins, buttocks, fingers, toes, hands, or feet. If you inject a young child with Epinephrine Injection (Auto-Injector), hold their leg firmly in place before and during the injection to prevent injuries. If you accidentally inject Epinephrine Injection (Auto-Injector) into any other part of your body, go to the nearest emergency room right away. Tell the healthcare provider where on your body you received the accidental injection.

Rarely, patients who have used Epinephrine Injection (Auto-Injector) may develop infections at the injection site within a few days of an injection. Some of these infections can be serious. Call your healthcare provider right away if you have any of the following at an injection site: redness that does not go away, swelling, tenderness, or the area feels warm to the touch.

If you have certain medical conditions, or take certain medicines, your condition may get worse or you may have longer lasting side effects when you use your Epinephrine Injection (Auto-Injector). Tell your healthcare provider about all known allergies, all your medical conditions and all the medicines you take, especially if you take asthma medicines.

Common side effects of Epinephrine Injection (Auto-Injector) include: fast, irregular or “pounding” heartbeat; sweating; headache; weakness; shakiness; paleness; feelings of over excitement, nervousness or anxiety; dizziness; nausea or vomiting; and breathing problems. These side effects may go away with rest. Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of Epinephrine Injection (Auto-Injector). For more information, ask your healthcare provider or pharmacist. Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

For more information, please see accompanying Full Prescribing Information.

A copy may be requested from Teva US Medical Information at 888-TEVA-USA (888-838-2872) or [email protected], or Teva’s Public Relations or Investor Relations contacts.

About Teva

Teva Pharmaceutical Industries Ltd. (NYSE and TASE: TEVA) has been developing and producing medicines to improve people’s lives for more than a century. We are a global leader in generic and specialty medicines with a portfolio consisting of over 3,500 products in nearly every therapeutic area. Around 200 million people around the world take a Teva medicine every day, and are served by one of the largest and most complex supply chains in the pharmaceutical industry. Along with our established presence in generics, we have significant innovative research and operations supporting our growing portfolio of specialty and biopharmaceutical products. Learn more at www.tevapharm.com.

Cautionary Note Regarding Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 regarding Teva’s generic version of the EpiPen®, which are based on management’s current beliefs and expectations and are subject to substantial risks and uncertainties, both known and unknown, that could cause our future results, performance or achievements to differ significantly from that expressed or implied by such forward-looking statements. Important factors that could cause or contribute to such differences include risks relating to:

  • the commercial success, including availability of sufficient supply, of Teva’s generic version of the EpiPen® and EpiPen Jr®;
  • our ability to successfully compete in the marketplace, including: that we are substantially dependent on our generic products; competition for our specialty products, especially COPAXONE®, our leading medicine, which faces competition from existing and potential additional generic versions and orally-administered alternatives; the uncertainty of commercial success of AJOVY® or AUSTEDO®; competition from companies with greater resources and capabilities; efforts of pharmaceutical companies to limit the use of generics, including through legislation and regulations; consolidation of our customer base and commercial alliances among our customers; the increase in the number of competitors targeting generic opportunities and seeking U.S. market exclusivity for generic versions of significant products; price erosion relating to our products, both from competing products and increased regulation; delays in launches of new products and our ability to achieve expected results from investments in our product pipeline; our ability to take advantage of high-value opportunities; the difficulty and expense of obtaining licenses to proprietary technologies; and the effectiveness of our patents and other measures to protect our intellectual property rights
  • our substantial indebtedness, which may limit our ability to incur additional indebtedness, engage in additional transactions or make new investments, may result in a further downgrade of our credit ratings; and our inability to raise debt or borrow funds in amounts or on terms that are favorable to us;
  • our business and operations in general, including: failure to effectively execute our restructuring plan announced in December 2017; uncertainties related to, and failure to achieve, the potential benefits and success of our senior management team and organizational structure; harm to our pipeline of future products due to the ongoing review of our R&D programs; our ability to develop and commercialize additional pharmaceutical products; potential additional adverse consequences following our resolution with the U.S. government of our FCPA investigation; compliance with sanctions and other trade control laws; manufacturing or quality control problems, which may damage our reputation for quality production and require costly remediation; interruptions in our supply chain; disruptions of our or third party information technology systems or breaches of our data security; the failure to recruit or retain key personnel; variations in intellectual property laws that may adversely affect our ability to manufacture our products; challenges associated with conducting business globally, including adverse effects of political or economic instability, major hostilities or terrorism; significant sales to a limited number of customers in our U.S. market; our ability to successfully bid for suitable acquisition targets or licensing opportunities, or to consummate and integrate acquisitions; implementation of a new enterprise resource planning system that, if deficient, could materially and adversely affect our operations and/or the effectiveness of our internal controls; and our prospects and opportunities for growth if we sell assets;
  • compliance, regulatory and litigation matters, including: costs and delays resulting from the extensive governmental regulation to which we are subject; the effects of reforms in healthcare regulation and reductions in pharmaceutical pricing, reimbursement and coverage; increased legal and regulatory action in connection with public concern over the abuse of opioid medications in the U.S.; governmental investigations into selling and marketing practices; potential liability for patent infringement; product liability claims; increased government scrutiny of our patent settlement agreements; failure to comply with complex Medicare and Medicaid reporting and payment obligations; and environmental risks;
  • other financial and economic risks, including: our exposure to currency fluctuations and restrictions as well as credit risks; potential impairments of our intangible assets; potential significant increases in tax liabilities; and the effect on our overall effective tax rate of the termination or expiration of governmental programs or tax benefits, or of a change in our business;

and other factors discussed in our Quarterly Reports on Form 10-Q for the first and second quarter of 2019 and in our Annual Report on Form 10-K for the year ended December 31, 2018, including in the sections captioned “Risk Factors” and “Forward Looking Statements.” Forward-looking statements speak only as of the date on which they are made, and we assume no obligation to update or revise any forward-looking statements or other information contained herein, whether as a result of new information, future events or otherwise. You are cautioned not to put undue reliance on these forward-looking statements.

1 EpiPen® and EpiPen Jr® are registered trademarks of Mylan® Inc.

2 Teva does not set the price that a pharmacy charges for a particular drug and does not have visibility or control into the price of the drug in the marketplace.

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about epinephrine injection, USP auto-injector?

    1. Epinephrine injection, USP auto-injector contains epinephrine, a medicine used to treat allergic emergencies (anaphylaxis). Anaphylaxis can be life-threatening, can happen within minutes, and can be caused by stinging and biting insects, allergy injections, foods, medicines, exercise or other unknown causes. Symptoms of anaphylaxis may include:
      • trouble breathing
      • wheezing
      • hoarseness (changes in the way your voice sounds)
      • hives (raised reddened rash that may itch)
      • severe itching
      • swelling of your face, lips, mouth, or tongue
      • skin rash, redness, or swelling
      • fast heartbeat
      • weak pulse
      • feeling very anxious
      • confusion
      • stomach pain
      • losing control of urine or bowel movements (incontinence)
      • diarrhea or stomach cramps
      • dizziness, fainting, or “passing out” (unconsciousness).
    2. Always carry your epinephrine injection, USP auto-injector with you because you may not know when anaphylaxis may happen. Talk to your healthcare provider if you need additional units to keep at work, school, or other locations. Tell your family members, caregivers, and others where you keep your epinephrine injection, USP auto-injector and how to use it before you need it. You may be unable to speak in an allergic emergency.
    3. When you have an allergic emergency (anaphylaxis)
      • Use epinephrine injection, USP auto-injector right away.
      • Get emergency medical help right away. You may need further medical attention. You may need to use a second epinephrine injection, USP auto-injector if symptoms continue or recur. Only a healthcare provider should give additional doses of epinephrine if you need more than 2 injections for a single anaphylaxis episode.

    What is epinephrine injection, USP auto-injector?

    • Epinephrine injection, USP auto-injector is a disposable, prefilled automatic injection device (auto-injector) used to treat life-threatening, allergic emergencies including anaphylaxis in people who are at risk for or have a history of serious allergic emergencies. Each device contains a single dose of epinephrine.
    • Epinephrine injection, USP auto-injector is for immediate self (or caregiver) administration and does not take the place of emergency medical care. You should get emergency medical help right away after using epinephrine injection, USP auto-injector.
    • Epinephrine injection, USP auto-injector is for people who have been prescribed this medicine by their healthcare provider.

    What should I tell my healthcare provider before using epinephrine injection, USP auto-injector? Before you use epinephrine injection, USP auto-injector, tell your healthcare provider about all your medical conditions, especially if you:

    • have heart problems or high blood pressure
    • have diabetes
    • have thyroid problems
    • have asthma
    • have a history of depression
    • have Parkinson’s disease
    • have any other medical condition
    • are pregnant or plan to become pregnant
    • are breastfeeding or plan to breastfeed

    Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Tell your healthcare provider of all known allergies. Especially tell your healthcare provider if you take certain asthma medicines.

    How should I use epinephrine injection, USP auto-injector?

    • Each epinephrine injection, USP auto-injector contains only 1 dose of medicine.
    • Epinephrine injection, USP auto-injector should only be injected into the middle of the outer thigh (upper leg). It can be injected through clothing, if needed.
    • Read the Instructions for Use in the Patient Information Leaflet for information about the right way to use epinephrine injection, USP auto-injector.
    • Your healthcare provider will show you how to safely use the epinephrine injection, USP auto-injector.
    • Use epinephrine injection, USP auto-injector exactly as your healthcare provider tells you to use it.

    What are the possible side effects of epinephrine injection, USP auto-injector? Epinephrine injection, USP auto-injector may cause serious side effects.

    • Epinephrine injection, USP auto-injector should only be injected into the middle of your outer thigh (upper leg). Do not inject epinephrine injection, USP auto-injector into your veins, buttocks, fingers, toes hands or feet.

    If you accidently inject epinephrine injection, USP auto-injector into any other part of your body, go to the nearest emergency room right away. Tell the healthcare provider where on your body you received the accidental injection.

    • Rarely patients who use epinephrine injection, USP auto-injector may develop infections at the injection site within a few days of an injection. Some of these infections can be serious. Call your healthcare provider right away if you have any of the following at an injection site:
      • redness that does not go away
      • swelling
      • tenderness
      • the area feels warm to the touch
    • If you inject a young child with epinephrine injection, USP auto-injector, hold their leg firmly in place before and during the injection to prevent injuries.
    • If you have certain medical conditions, or take certain medicines, your condition may get worse or you may have more or longer lasting side effects when you use epinephrine injection, USP auto-injector. Talk to your healthcare provider about all your medical conditions.

    Common side effects of epinephrine injection, USP auto-injector include

    • faster, irregular or “pounding” heartbeat
    • sweating
    • headache
    • weakness
    • shakiness
    • paleness
    • feelings of over excitement, nervousness, or anxiety
    • dizziness
    • nausea or vomiting
    • breathing problems

    These side effects may go away with rest. Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of epinephrine injection, USP auto-injector. For more information, ask your healthcare provider or pharmacist. Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

    Keep epinephrine injection, USP auto-injector and all medicines out of the reach of children.

    What are the ingredients in epinephrine injection, USP auto-injector? Active Ingredient: epinephrine Inactive Ingredients: sodium chloride, chlorobutanol, sodium bisulfite, hydrochloric acid and sodium hydroxide, and water.

    You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. To report SUSPECTED ADVERSE REACTIONS contact Impax Laboratories, Inc. at 1-877-994-6729. Please click here for full Prescribing Information including the Patient Information Leaflet.

    For more information and video instructions on the use of epinephrine injection, USP auto-injector, go to www.epinephrineautoinject.com or call 1-800-934-6729.

    Indication: The epinephrine injection, USP auto-injector is a disposable, prefilled automatic injection device (auto-injector) used to treat life-threatening, allergic emergencies including anaphylaxis in people who are at risk for or have a history of serious allergic emergencies.

Epinephrine injection

Medically reviewed by Drugs.com on Apr 17, 2019 – Written by Cerner Multum

  • Overview
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What is epinephrine injection?

Epinephrine is a chemical that narrows blood vessels and opens airways in the lungs. These effects can reverse severe low blood pressure, wheezing, severe skin itching, hives, and other symptoms of an allergic reaction.

Epinephrine injection is used to treat severe allergic reactions (anaphylaxis) to insect stings or bites, foods, drugs, and other allergens.

Epinephrine auto-injectors may be kept on hand for self-injection by a person with a history of severe allergic reaction.

Epinephrine is also used to treat exercise-induced anaphylaxis, or to treat low blood pressure that is caused by septic shock.

Epinephrine injection may also be used for purposes not listed in this medication guide.

Important Information

Seek emergency medical attention after any use of epinephrine to treat a severe allergic reaction. After the injection you will need to receive further treatment and observation.

Before taking this medicine

Before using epinephrine, tell your doctor if any past use of epinephrine injection caused an allergic reaction to get worse.

Tell your doctor if you have ever had:

  • heart disease or high blood pressure;

  • asthma;

  • Parkinson’s disease;

  • depression or mental illness;

  • a thyroid disorder; or

  • diabetes.

Having an allergic reaction while pregnant or nursing could harm both mother and baby. You may need to use epinephrine during pregnancy or while you are breast-feeding. Seek emergency medical attention right away after using the injection.

In an emergency, you may not be able to tell caregivers if you are pregnant or breast feeding. Make sure any doctor caring for your pregnancy or your baby knows you received this medicine.

How should I use epinephrine injection?

Epinephrine is injected into the skin or muscle of your outer thigh. In an emergency, this injection can be given through your clothing.

Epinephrine is sometimes given as an infusion into a vein. A healthcare provider will give you this type of injection.

The auto-injector device is a disposable single-use system. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Do not give this medicine to a child without medical advice.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Do not remove the safety cap until you are ready to use the auto-injector. Never put your fingers over the injector tip after the safety cap has been removed.

To use an epinephrine auto-injector:

  • Form a fist around the auto-injector with the tip pointing down. Pull off the safety cap.

  • Place the tip against the fleshy portion of the outer thigh. You may give the injection directly through clothing. Hold the leg firmly when giving this injection to a child or infant.

  • Push the auto-injector firmly against the thigh to release the needle that injects the dose of epinephrine. Hold the auto-injector in place for 10 seconds after activation.

  • Remove the auto-injector from the thigh and massage the area gently. Carefully re-insert the used device needle-first into the carrying tube. Re-cap the tube and take it with you to the emergency room so that anyone who treats you will know how much epinephrine you have received.

  • Use an auto-injector only one time. Do not try to reinsert an auto-injector a second time if the needle has come out of your skin before the full 10 seconds. If the needle is bent from the first use, it may cause serious injury to your skin.

Seek emergency medical attention after any use of epinephrine. The effects of epinephrine may wear off after 10 or 20 minutes. You will need to receive further treatment and observation.

Do not use epinephrine injection if it has changed colors or has particles in it, or if the expiration date on the label has passed. Call your pharmacist for a new prescription.

Your medicine may also come with a “trainer pen.” The trainer pen contains no medicine and no needle. It is only for non-emergency use to practice giving yourself an epinephrine injection.

Store at room temperature away from moisture, heat, and light. Do not refrigerate or freeze this medication, and do not store it in a car.

What happens if I miss a dose?

Since epinephrine is used when needed, it does not have a daily dosing schedule.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Symptoms of an epinephrine overdose may include numbness or weakness, severe headache, blurred vision, pounding in your neck or ears, sweating, chills, chest pain, fast or slow heartbeats, severe shortness of breath, or cough with foamy mucus.

What should I avoid while using epinephrine injection?

Do not inject epinephrine into a vein or into the muscles of your buttocks, or it may not work as well. Inject it only into the fleshy outer portion of the thigh.

Accidentally injecting epinephrine into your hands or feet may result in a loss of blood flow to those areas, and resulting numbness.

Epinephrine injection side effects

Before using epinephrine, tell your doctor if any past use of epinephrine injection caused an allergic reaction to get worse.

Call your doctor at once if you notice pain, swelling, warmth, redness, or other signs of infection around the area where you gave an injection.

Common side effects may include:

  • breathing problems;

  • fast or pounding heartbeats;

  • pale skin, sweating;

  • nausea and vomiting;

  • dizziness;

  • weakness or tremors;

  • throbbing headache; or

  • feeling nervous, anxious, or fearful.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect epinephrine injection?

Other drugs may affect epinephrine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 12.02.

Related questions

  • Norepinephrine vs epinephrine: what’s the difference?

Medical Disclaimer

More about epinephrine

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Adrenaline Injection

Generic Name: Adrenaline acid tartrate
Product Name: Adrenaline Injection

Indication

Adrenaline is a drug that leads to increased blood pressure, increased heart rate, increased air entry, increased blood glucose, stimulates cardiac activity and reduce allergic reactions by reducing inflammatory response caused by histamine. Adrenaline action is fast yet it has a short duration. Due to these properties, it is used for the treatment of allergic and anaphylactic reactions (e.g. drug reactions, insect stings, food allergies).

Dose advice

  • There are no absolute contraindications to adrenaline in severe life-threatening situations requiring the use of it. However, care should be taken when giving adrenaline to the elderly and individuals with ischemic and/or cerebrovascular disease
  • Adrenaline is only for subcutaneous or intramuscular use. It is not an intravenous drug.
  • It’s essential that patients understand how, when and where to give themselves an adrenaline injection.
  • Do not use if the injection is brown or contains a precipitate.
  • The adrenaline is supplied as a single use prefilled syringe. After using the drug, discard the syringe with any remaining solution.
  • It’s pertinent that patients seek medical advice soon after administering an adrenaline injection so that patient is monitored.
  • Adrenaline should be stored in the dark and below 25 degrees; however, it should not be refrigerated.
  • It’s important to check the use by date prior to use and to restock the drug in advance.

Schedule

1 mg/10 mL (1:10,000): Unscheduled; 1 mg/mL (1:1,000):

Schedule 3

Common side effects

Common side effects include agitation , increased heart rate, sweating, sleeplessness, fatigue, dizziness, hallucinations, impaired memory, weakness, disoriention, breathlessness, reddening of the skin and face, cold fingers and toes, increase blood sugar levels and raised blood pressure.

Uncommon side effects

Uncommon side effects include severe hypertension, cardiac arrhythmias, pulmonary oedema and cerebral haemorrhage.

  1. Bochner, F. Australian Medicines Handbook. Australian Medicines Handbook Pty Ltd. Adelaide 2005; pp 2-5.

For further information talk to your doctor.

You and Your Hormones

Alternative names for adrenaline

Epinephrine

What is adrenaline?

Image of an eye showing a dilated or enlarged pupil – one of the effects of adrenaline released during a ‘fight or flight’ response.

Adrenaline and noradrenline are two separate but related hormones and neurotransmitters. They are produced in the centre (medulla) of the adrenal glands and in some neurons of the central nervous system. They are released into the bloodstream and serve as chemical mediators, and also convey the nerve impulses to various organs. Adrenaline has many different actions depending on the type of cells it is acting upon. However, the overall effect of adrenaline is to prepare the body for the ‘fight or flight’ response in times of stress, i.e. for vigorous and/or sudden action. Key actions of adrenaline include increasing the heart rate, increasing blood pressure, expanding the air passages of the lungs, enlarging the pupil in the eye (see photo), redistributing blood to the muscles and altering the body’s metabolism, so as to maximise blood glucose levels (primarily for the brain). A closely related hormone, noradrenaline, is released mainly from the nerve endings of the sympathetic nervous system (as well as in relatively small amounts from the adrenal medulla). There is a continuous low level of activity of the sympathetic nervous system resulting in release of noradrenaline into the circulation, but adrenaline release is only increased at times of acute stress.

How is adrenaline controlled?

Adrenaline is released mainly through the activation of nerves connected to the adrenal glands, which trigger the secretion of adrenaline and thus increase the levels of adrenaline in the blood. This process happens relatively quickly, within 2 to 3 minutes of the stressful event being encountered. When the stressful situation ends, the nerve impulses to the adrenal glands are lowered, meaning that the adrenal glands stop producing adrenaline.

Stress also stimulates the release of adrenocorticotropic hormone from the pituitary gland, which promotes the production of the steroid hormone cortisol from the cortex of the adrenal glands. This steroid hormone is more important in altering the body’s metabolism (i.e. raising plasma glucose) under conditions of longer-term, ongoing (chronic), rather than acute, stress.

What happens if I have too much adrenaline?

Overproduction of adrenaline is very common. Most people are exposed to stressful situations on occasion and so most of us are familiar with the typical symptoms of adrenaline release, such as: rapid heartbeat, high blood pressure, anxiety, weight loss, excessive sweating and palpitations. However, this is a normal response of the body which is intended to help us respond to a stressful situation; once the acute stress is over, the symptoms quickly disappear as adrenaline hyper-secretion stops. Some people with obesity and untreated obstructive sleep apnea may be exposed to high levels of noradrenaline/adrenaline each night as they struggle to breathe; this might play a role in the development of high blood pressure in such people.

Very rarely, overproduction of adrenaline/noradrenaline may be caused by an adrenal tumour called pheochromocytoma or a paraganglioma (if it is located outside the adrenal but along the nerves of sympathetic nervous system that run through the chest and abdomen). Such tumours may run in families as well. The symptoms can include the typical symptoms of adrenaline excess on an intermittent basis but, in some cases, the symptoms can be quite mild so as to be barely noticeable.

What happens if I have too little adrenaline?

Suffering from too little adrenaline is very unusual, even if you have lost both adrenal glands through disease or surgery. Since 90% of the body’s noradrenaline comes from the nervous system, the loss of 10% via the adrenal glands is not really significant. ‘Adrenaline deficiency’ therefore does not really show up as a medical disorder except perhaps in exceedingly rare and unusual genetic catecholamine enzyme deficiencies.

Last reviewed: Jan 2018

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Adrenocorticotropic hormone

Adrenalin

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 2/11/2019

Adrenalin (epinephrine) is a chemical that narrows blood vessels and opens airways in the lungs. These effects can reverse severe low blood pressure, wheezing, severe skin itching, hives, and other symptoms of an allergic reaction. An injection of adrenalin is used to treat severe allergic reactions (anaphylaxis) to insect stings or bites, foods, drugs, and other allergens. Side effects of Adrenalin include:

Before using Adrenalin a second time, tell your doctor if your first injection caused serious side effects such as increased breathing difficulty, or dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Adrenalin is available in many different injectable forms including auto-injector systems that can be carried by those who are prone to serious allergic reactions. The dose for adults and children 30 kg (66 lbs) or more is 0.3 to 0.5 mg (0.3 mL to 0.5 mL) of undiluted Adrenalin administered intramuscularly or subcutaneously in the anterolateral aspect of the thigh, up to a maximum of 0.5 mg (0.5 mL) per injection, repeated every 5 to 10 minutes as necessary. Adrenalin may interact with digoxin, diuretics (water pills), levothyroxine, chlorpheniramine or diphenhydramine (antihistamines commonly contained in cold, allergy, or over-the-counter sleep medications), antidepressants, beta-blockers, ergot medicines, heart rhythm medications, or MAO inhibitors. Tell your doctor all medications and supplements you use. There are no adequate and well-controlled studies in pregnant women. Tell your doctor if you are pregnant before using Adrenalin. Consult your doctor before breastfeeding.

Our Adrenalin Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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