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Epinephrine

Adrenaline

RA
UR

Written by R. Author | Reviewed by Uche Ruth

Updated on July 02, 2024

Overview

Epinephrine, commonly known as adrenaline and available as an EpiPen, is an injectable medication crucial for treating anaphylaxis symptoms. It comes in a pre-filled syringe and an auto-injector for administration into the muscle or subcutaneously in the mid-outer thigh. Epinephrine can help stabilize blood pressure and heart rate, and improve breathing. Possible side effects may include restlessness, elevated blood pressure, and an increased heart rate.

What is Epinephrine (Epipen) used for?

How Epinephrine (Epipen) works

Epinephrine (Epipen) is a non-selective alpha- and beta-adrenergic receptor agonist that acts on receptors throughout the body. In doing so, it keeps your blood pressure from dropping too low, raises your heart rate, and opens your lungs so you can breathe normally. It also helps with swelling, itching, rashes, hives, and stomach issues linked to an allergic reaction.

Pros and cons of Epinephrine (Epipen)

pros and cons

Pharmacist tips for Epinephrine (Epipen)

  • Always carry epinephrine (Epipen) with you at all times so you can be prepared in case you have an allergic reaction.
  • Make sure you're able to recognize the symptoms of anaphylaxis and know how to correctly give yourself epinephrine (Epipen) injections.
  • Each brand-name product of epinephrine might have slightly different directions, so be sure to review the instructions for your particular product: EpiPen, EpiPen JR, Adrenaclick, Symjepi. It's also a good idea to go over this information with friends or family members because you might need their help with this medication in emergency situations.
  • Inject the medication only into the middle of the outer thigh. Never inject into other parts of the body because the medication might not work as well. If necessary, you can inject through clothing. Never put your thumbs, fingers, or hand over the exposed needle.
  • If you're giving epinephrine (Epipen) to a child, make sure to hold their leg down firmly to prevent it from moving around too much. Doing so will make sure that the needle from the device doesn't break, get stuck in the skin, or accidentally cut through the child's skin during the injection process.
  • The auto-injector device or prefilled syringe delivers a single dose. Once it's been activated and used, don't try to reuse the same device or syringe again. It's normal if some medication still remains in the device after use. If you need to repeat a second dose, make sure to use a brand-new device or syringe.
  • Store epinephrine (Epipen) at room temperature in the original container to protect it from light. Don't expose the medication to extreme heat (e.g., car glovebox) or cold (e.g., refrigerator or freezer) because this can damage the medication and make it not work well for you. If you do, throw it away and use a new prefilled syringe or device, or ask your provider for a new prescription.

Strengths

Package

  • 2 auto-injectors of 0.3mg

Dosages

Your provider will prescribe epinephrine (Epipen) based on your body weight. Epinephrine (Epipen) is available as a prefilled syringe or device that contains a single and complete dose.

You can inject the medication into the muscle or under the skin in the middle of the outer thigh (even through clothing) when you feel an allergic reaction. Call 911. While you're waiting for help to arrive, you can repeat the dose if symptoms don't go away.

  • 66 lbs or more: The typical dose is 0.3 mg.
  • 33 lbs to 66 lbs: The typical dose is 0.15 mg.

Epinephrine injection is available in multiple brand names (e.g., EpiPen, EpiPen Jr, Symjepi).

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Interactions

Epinephrine (Epipen) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Epinephrine (Epipen). Please note that only the generic name of each medication is listed below.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Side-effects

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Feeling anxious, nervous, or restless
  • Shaking or tremors
  • Weakness
  • Dizziness
  • Sweating
  • Racing heart

Other Side Effects

  • Pale skin color
  • Nausea or vomiting
  • Headache
  • Difficulty breathing

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.

  • Irregular heart rhythm (arrhythmias): fatigue, weakness, dizziness, shortness of breath, chest pain, sweating
  • High blood pressure: headache, chest pain, dizziness, blurry vision
  • Serious infection at injection site: skin redness, tenderness, swelling, warmth

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

  • Abnormal or decreased touch sensation
  • Anxiety
  • Arm, back, or jaw pain
  • Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
  • Blurred vision
  • Chest pain, tightness, heaviness, or discomfort
  • Cold, pale, or bluish color of the skin of the fingers or toes
  • Confusion
  • Difficulty in speaking
  • Dizziness
  • Double vision
  • Fainting
  • Fast, slow, irregular, pounding, or racing heartbeat or pulse
  • Headache
  • Inability to move the arms, legs, or facial muscles
  • Inability to speak
  • Nausea
  • Numbness, tingling, or pain in the fingers
  • Paleness of the skin
  • Pounding in the ears
  • Restlessness
  • Shakiness in the legs, arms, hands, or feet
  • Slow speech
  • Sweating
  • Trembling or shaking of the hands or feet
  • Trouble breathing
  • Unusual tiredness or weakness
  • Vomiting

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

  • Agitation
  • Coldness of the skin
  • Confusion
  • Decreased awareness or responsiveness
  • Decreased urine output
  • Depression
  • Drowsiness
  • Hostility
  • Irritability
  • Lightheadedness
  • Loss of consciousness
  • Muscle twitching
  • Rapid weight gain
  • Rapid, deep breathing
  • Seizures
  • Severe sleepiness
  • Stomach cramps
  • Swelling of the face, ankles, or hands
  • Unusual drowsiness, dullness, or feeling of sluggishness

Common Concerns

At the first sign of a severe allergic reaction, inject epinephrine (Epipen) into the muscle, or under the skin, into the side of your thigh. If needed, you can give epinephrine (Epipen) through clothing. Never inject epinephrine (Epipen) into the veins or into any other part of your body. Each pre-filled syringe or device contains one dose. Each brand-name product of epinephrine might have slightly different directions. Make sure to review the instructions for your particular product and ask your provider or pharmacist if you have any questions.
Epinephrine (Epipen) works very quickly to relieve symptoms of a serious allergic reaction. But its effects don't last very long. Remember to get medical help right away after you use epinephrine (Epipen). This is because epinephrine (Epipen) wears off quickly and there's a risk that you can have another reaction in minutes or hours. If needed, you can give yourself another dose of epinephrine (Epipen) while waiting for medical help to arrive. But if you need more than two doses of epinephrine (Epipen), it should be done under the supervision of a healthcare provider. This is because you might need to use other medications and possibly stay in the hospital to treat your severe allergic reactions.
Yes, epinephrine (Epipen) raises your blood pressure and heart rate. A severe allergic reaction is life-threatening because it can cause your blood pressure and heart rate to drop. So epinephrine (Epipen) is helpful in someone who's having an allergic reaction because it raises blood pressure and heart rate so that blood continues to flow properly throughout your body.
Yes, epinephrine (also called the hormone adrenaline) is a hormone that's normally made in your adrenal glands. The overall purpose of epinephrine is to prepare your body for the "fight-or-flight" response to stress. It does this by raising your heart rate and blood pressure and opening your airways to make it easier to breathe. Epinephrine (Epipen) is a synthetic (man-made) version of natural epinephrine that has these same actions in your body during an allergic reaction.
No, epinephrine isn't a steroid; it's a hormone. But epinephrine can cause your body to release cortisol, which is a steroid hormone.

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