Epinephrine (Adrenaline)

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

EpiPen (auto-injector)

Popular combinations:

Several local anaesthetics (e.g. Xylocaine) – not discussed in this section

Drug group:

Drug for cardiac resuscitation and anaphylaxis

Prescription needed?

Yes

What does it do?

Epinephrine is used in the emergency treatment of:

• Cardiac arrest
• Severe allergic reactions (anaphylaxis) to drugs, food, or insect stings

It is also used in combination with local anaesthetics to prolong the effect of the anaesthetic, and reduce bleeding at incision sites.

How does it work?

• Epinephrine is a neurotransmitter that is produced in the centre of the adrenal glands
• It narrows blood vessels in the skin and intestines, and stimulates heart activity

How should it be used?

• Patients at risk of anaphylaxis should always keep an auto-injector close-by
• Use immediately at the first sign of an allergic reaction
• Teach friends and family when and how to use the auto-injector
• Always get medical help after using the auto-injector

What is the typical dosage?

• A pre-filled syringe, to be used on the thigh at the first sign of allergy
• Adults/children >45kg: Epipen auto-injector (0.3mg/0.3ml)
• Children <45kg: Epipen junior auto-injector (0.15mg/0.3ml)

How quickly will it start to work?

Within 5 minutes
                            

How long will the effects last?

Up to 4 hours
        

When should I stop using it?

The drug is used for one-off emergencies only
                                  

Is it safe for prolonged use?

Epinephrine is not normally used long term                                                        

What are the possible side effects?

The following have been reported:

• More common: dry mouth, nervousness, restlessness, nausea, vomiting, cold hands and feet, palpitations, headache, blurred vision
• Always report to your doctor after using the auto-injector

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: heart problems, overactive thyroid gland, high blood pressure
• Other medicines: many potential drug interactions but these are not important because epinephrine is used to treat life-threatening emergencies
• Pregnancy and breast-feeding: may cause foetal defects but its use may be life-saving
• Children: Reduced dose necessary
• Over 60: Reduced dose may be necessary
• Driving and hazardous work: Not applicable
• Alcohol: No known problems
• Surgery and general anaesthetics: discuss with your doctor if you have used or been treated with epinephrine within the past 24 hours