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
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
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.
Epinephrine Side Effects
- Nausea or vomiting
- Difficulty breathing
- Pounding, fast, or irregular heartbeat
- Pale skin
- Headache
- Sweating
- Dizziness
- Nervousness, anxiety, or restlessness
- Weakness
- Uncontrollable shaking
Epinephrine Interactions
- Antidepressants such as amitriptyline (Elavil), amoxapine, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), maprotiline (Ludiomil), mirtazapine (Remeron), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil)
- Antihistamines, such as chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl) and hydroxyzine (Atarax)
- Beta blockers, such as propranolol (Inderal) or metoprolol (Lopressor)
- Digoxin (Digitek, Lanoxicaps, Lanoxin)
- Diuretics (often called "water pills")
- Ergot medications, such as dihydroergotamine (D.H.E. 45, Migranal), ergoloid mesylates (Hydergine), ergonovine (Ergotrate), ergotamine (in Cafergot and Migergot), methylergonovine (Methergine), and methysergide (Sansert)
- Levothyroxine (Levothroid, Levoxyl, Synthroid, Unithroid)
- Medications for irregular heartbeat, such as quinidine
Epinephrine Dosage
You should inject epinephrine as needed at the first sign of a serious allergic reaction. Always follow the directions on your prescription label.
Don't take larger or smaller amounts of epinephrine than are recommended.
The medicine can be injected through clothing if needed in an emergency.
However, it should only be injected in the middle of the outer side of the thigh. (The goal of injection is to deliver the epinephrine into muscle tissue.)
Do not inject epinephrine into the buttocks or any other part of your body.
After using an auto-injector, some epinephrine may still remain in the device. This is typical and doesn't mean you did not receive a full dose.
Do not inject any remaining solution.
Epinephrine Overdose
Symptoms of an overdose include the following:- Chest pain
- Fast or irregular heartbeat
- Shortness of breath
- Confusion
- Blurred vision
- Severe headache
You can call a poison control center at (800) 222-1222.
Missed Dose of Epinephrine
Epinephrine is typically used only as needed in an emergency, so you are unlikely to be on a dosing schedule or miss a dose of this medicine.You should not repeat doses of this drug without your doctor's advice.
