Adrenalin

By Medically reviewed by hellodoktor

Generic Name: Adrenalin Brand Name(s): Adrenalin and Adrenalin.

Uses

What is Adrenalin® (epinephrine) used for?

Adrenalin® solution is a sympathomimetic. It works on blood vessels to improve blood pressure and on the smooth muscle of the lungs to help to breathe. It also works by decreasing rash, hives, and swelling. It works in the eye to widen the pupil during eye surgery.

Adrenalin® is commonly used for treating severe allergic reactions (e.g., difficulty breathing; rash; hives; itching; tightness in the chest; severe dizziness; swelling of the mouth, lips, or tongue) caused by insect stings or bites, foods, drugs, or other causes.

It is also used in the eye to dilate (widen) the pupil during eye surgery.

Adrenalin® may also be used for other conditions as determined by your doctor.

How should I take Adrenalin® (epinephrine)?

For treating allergic reactions: 

Adrenalin® solution may be given as an injection at your doctor’s office, hospital, or clinic. If you will be using Adrenalin® solution at home, a health care provider will teach you how to use it. Be sure you understand how to use Adrenalin® solution. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.

For eye surgery: 

Adrenalin® solution is given as an injection into the eye at your doctor’s office, hospital, or clinic.

Do not use Adrenalin® solution if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.

Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.

Ask your health care provider any questions you may have about how to use Adrenalin® solution.

How do I store Adrenalin® (epinephrine)?

Adrenalin® is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Adrenalin® in the bathroom or the freezer. There may be different brands of Adrenalin® that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Adrenalin® down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Adrenalin® (epinephrine)?   

Before using Adrenalin® solution, tell your doctor if:

  • You are pregnant, planning to become pregnant, or are breastfeeding.
  • You are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement.
  • You have allergies to medicines, foods, or other substances (e.g., sulfites).
  • You are allergic to any ingredient in Adrenalin® solution, unless your doctor tells you otherwise.

Do not inject Adrenalin® solution into the buttocks. It may not provide effective treatment of an allergic reaction and could cause gangrene.

Never inject Adrenalin® solution into hands, fingers, feet, or toes. Doing so may cause a loss of blood flow and result in tissue damage to these areas. If you accidentally inject Adrenalin® solution into any of these areas, seek immediate emergency medical attention.

After eye surgery with Adrenalin® solution, your eyes may be more sensitive to light. Wearing sunglasses may help. Talk with your doctor.

Diabetes patients – Adrenalin® solution may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur or persist, tell your doctor right away.

Patients with Parkinson disease may notice a temporary worsening of symptoms (e.g., uncontrolled muscle movements). If these symptoms persist, contact your doctor.

Use Adrenalin® solution with caution in the elderly; they may be more sensitive to its effects.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using Adrenalin® during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Adrenalin®. Adrenalin® is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Lactation: Unknown if excreted into breast milk; use caution.

Side effects

What side effects can occur from Adrenalin® (epinephrine)?

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most common side effects persist or become bothersome:

  • Anxiety
  • Dizziness
  • Headache
  • Nausea
  • Nervousness
  • Paleness
  • Restlessness
  • Shakiness
  • Sweating
  • Vomiting
  • Weakness

Seek medical attention right away if any of these severe side effects occur:

  • Rash
  • Hives
  • Itching
  • Difficulty breathing
  • Tightness in the chest
  • Swelling of the mouth, face, lips, or tongue
  • Chest pain
  • Fast or irregular heartbeat
  • Severe or persistent headache or dizziness
  • Wheezing

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Adrenalin® (epinephrine)?

Adrenalin® may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products may interact with your drug, including:

  • Alpha-blockers (e.g., prazosin), beta-blockers (e.g., propranolol), droxidopa, ergot alkaloids (e.g., ergotamine), or phenothiazines (e.g., chlorpromazine) because the risk of high or low blood pressure and fast or slow heartbeat may be increased.
  • Bromocriptine, furazolidone, linezolid, or tricyclic antidepressants (e.g., amitriptyline) because the risk of side effects, such as headache, high temperature, and high blood pressure, may be increased.
  • Antihistamines (e.g., diphenhydramine), catechol-O-methyltransferase (COMT) inhibitors (e.g., entacapone), digoxin, diuretics (e.g., furosemide, hydrochlorothiazide), levothyroxine, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), or medicines for irregular heartbeat (e.g., quinidine) because they may increase the risk of Adrenalin® solution’s side effects.
  • Guanethidine because its effectiveness may be decreased by Adrenalin® solution.

Does food or alcohol interact with Adrenalin® (epinephrine)?

Adrenalin® may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Adrenalin® (epinephrine)

Adrenalin® may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

These health conditions are:

  • Glaucoma
  • Heart disease
  • Chest pain
  • High blood pressure
  • Blood vessel problems
  • Diabetes
  • Parkinson disease
  • Thyroid problems
  • Adrenal gland problems (e.g., pheochromocytoma)
  • Mood or mental problems (e.g., depression)
  • Asthma
  • An irregular heartbeat

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Adrenalin® (epinephrine).

What is the dose of Adrenalin® (epinephrine) for an adult?

Cardiac Arrest

The recommended dose is 1 mg IV/IO q3-5min PRN; may administer up to 0.2 mg/kg if no response.

Dose >1 mg not shown to improve survival or neurological outcomes as compared to standard dosing; not recommended.

ET: 2-2.5 mg q3-5min until IV/IO access established or spontaneous circulation restored.

Asthma, Severe/Anaphylaxis

The recommended dose is 0.2-0.5 mg IM/SC q5-15min (1:1,000 solution; 1 mg/mL), clinician may shorten 5-min interval between injections for more frequent administration if deemed appropriate.

The recommended dose is 0.1 mg (1:10,000 solution; 0.1mg/mL) IV at rate of 1-4 mcg/min over 5 min to prevent the need to repeat injections frequently or may initiate with infusion at 5-15 mcg/min (with crystalloid administration); IV administration should only be done in patients who are profoundly hypotensive or are in cardiopulmonary arrest refractory to volume resuscitation and several epinephrine injections.

Auto-injector: 0.3 mg (contents of 1 auto-injector) SC/IM once in anterolateral aspect of the thigh; may repeat dose after 5-15 minutes if symptoms persist.

Symptomatic Bradycardia (Off-label)

Unresponsive to atropine or pacing: The recommended dose is 2-10 mcg//min by IV infusion or 0.1-0.5 mcg/kg/min (7-35 mcg/min in 70 kg patient); titrate to patient response.

What is the dose of Adrenalin® (epinephrine) for a child?

Asystole/Pulseless Arrest (Off-label)

1:10,000 solution: The recommended dose is 0.01 mg/kg (0.1 mg/mL) IO/IV; not to exceed 1 mg; repeat q3-5min until return of spontaneous circulation.

The recommended dose is 0.1 mg/kg (0.1 mL/kg of 1:1000 solution; 1 mg/mL) endotracheal; not to exceed 2.5 mg q3-5min until IO/IVP access established or spontaneous circulation achieved; flush with 5 mL of normal saline immediately after administration.

Symptomatic Bradycardia (Off-label)

1:10,000 solution: The recommended dose is 0.01 mg/kg IO/IV q3-5min; not to exceed 1 mg.

1:1,000 solution: The recommended dose is 0.1 mg/kg (0.1mL/kg) of endotracheal q3-5min if necessary; flush each dose with at least 5 mL isotonic sodium chloride injection.

Neonates (<28 days old): The recommended dose is 0.01-0.03 mg/kg IVP (1:10,000 solution) q3-5min; higher doses not recommended.

Neonate IV access not available: 0.05-0.1 mg/kg endotracheal tube (1:10,000 soluiton); lower doses not effective; follow each dose with at least 5 mL isotonic sodium chloride injection.

Asthma/Anaphylaxis

The recommended dose is 0.01 mg/kg (0.01 mL/kg of 1:1,000 solution; 1 mg/mL) IM/SC q5-15min , clinician may shorten 5-min interval between injections for more frequent administration if deemed appropriate.

Auto-injector

  • Weight <30 kg: The recommended dose is 0.15 mg (contents of 1 auto-injector) SC/IM once; may repeat dose q5-15min.
  • Weight ≥30 kg: The recommended dose is 0.3 mg (contents of 1 auto-injector) SC/IM once; may repeat dose q5-15min.

How is Adrenalin® (epinephrine) available?

Adrenalin® is available in the following dosage forms and strengths:

  • Adrenalin® injectable solution 0.1mg/mL (1:10,000); 1mg/mL (1:1000)

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Adrenalin® solution, contact your doctor right away.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: April 24, 2017 | Last Modified: September 13, 2019

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