Epinephrine injection

Generic name: Epinephrine Injection
Dosage form: Injection vials, Auto-Injector

Usage of Epinephrine injection

Epinephrine injection is used to treat severe allergic reactions (anaphylaxis) to insect stings or bites, foods, drugs, and other allergens. Epinephrine is also used to treat low blood pressure that is caused by septic shock.

Epinephrine injection works to reverse wheezing, severe skin itching, hives, and other symptoms of an allergic reaction and also helps with severely low blood pressure. Epinephrine is a is a hormone and neurotransmitter that acts on alpha and beta receptors to cause the muscles in the airways to relax, and it causes the blood vessels to narrow. Epinephrine is from the drug class of medicine called sympathomimetics.

Epinephrine auto-injectors may be kept on hand for self-injection by a person with a history of severe allergic reactions. An Auto-Injector is a hand-held device that automatically injects a measured dose of medicine, it is easier to use in an emergency compared to using vials and needles.

Epinephrine is also known as adrenaline and adrenalin.

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.

Side effects may be more likely in older adults.

Common side effects of epinephrine injection may include:

breathing problems;

fast, irregular, or pounding heartbeats;

pale skin, sweating;

nausea and vomiting;

dizziness;

weakness or tremors;

headache; or

feeling restless, fearful, nervous, anxious, or excited.

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.

Before taking Epinephrine injection

Before using epinephrine auto injector or injection, 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 breastfeeding. Seek emergency medical attention right away after using the injection.

If possible, during an emergency, tell your medical caregivers if you are pregnant or breastfeeding.

How to use Epinephrine injection

Usual Adult Dose for Anaphylaxis

Auto-Injector: 30 kg or greater: 0.3 mg IM or suBCutaneously into the outer thigh (upper leg), repeat as needed. Comments:

The manufacturer's product information for the specific auto-injector being used should be consulted for administration instructions.

More than 2 sequential doses should only be administered under direct medical supervision.

The auto-injectors are intended for immediate administration as emergency supportive therapy only and not as a replacement or substitute for immediate medical care.

Injectable Solution of 1 mg/mL (1:1000):

30 kg or greater: 0.3 to 0.5 mg (0.3 to 0.5 mL) of undiluted drug IM or subcutaneously into the outer thigh (upper leg), repeat every 5 to 10 minutes as needed.

Maximum dose per injection: 0.5 mg (0.5 mL).

Comments:

For IM administration, use a long enough needle (at least 1/2 inch to 5/8 inch) to ensure injection into the muscle.

Repeated injections should not be administered at the same site as resulting vasoconstriction may cause tissue necrosis.

The patient should be monitored clinically for reaction severity and cardiac effects with repeat doses titrated to effect.

Injectable Solution of 0.1 mg/mL (1:10,000):

0.1 to 0.25 mg (1 to 2.5 mL) IV slowly once.

Convenience Kit 1 mg/mL (1:1000):

0.2 to 1 mg IM or subcutaneous.

Usual Pediatric Dose for Anaphylaxis

Auto-Injector: 7.5 to 15 kg: 0.1 mg IM or subcutaneously into the outer thigh (upper leg), repeat as needed. 15 to 30 kg: 0.15 mg IM or subcutaneously into the outer thigh (upper leg), repeat as needed. 30 kg or greater: 0.3 mg IM or subcutaneously into the outer thigh (upper leg), repeat as needed. Comments:

Since the lowest dose of the auto-injector is 0.1 mg, consider using other injectable forms of this drug if doses lower than 0.1 mg are necessary.

More than 2 sequential doses should only be administered under direct medical supervision.

The manufacturer product information for the specific auto-injector being used should be consulted for administration instructions.

Injectable Solution of 1 mg/mL (1:1000):

Less than 30 kg: 0.01 mg/kg (0.01 mL/kg) of undiluted drug IM or subcutaneously into the outer thigh (upper leg); repeat every 5 to 10 minutes as needed

Maximum dose per injection: 0.3 mg (0.3 mL)

30 kg or greater: 0.3 to 0.5 mg (0.3 to 0.5 mL) of undiluted drug IM or subcutaneously into the outer thigh (upper leg), repeat every 5 to 10 minutes as needed

Maximum dose per injection: 0.5 mg (0.5 mL)

Comments:

For IM administration, use a long enough needle (at least 1/2 inch to 5/8 inch) to ensure injection into the muscle.

Repeated injections should not be administered at the same site as resulting vasoconstriction may cause tissue necrosis.

The patient should be monitored clinically for reaction severity and cardiac effects with repeat doses titrated to effect.

Injectable Solution of 0.1 mg/mL (1:10,000):

Neonate: 0.01 mg/kg IV slowly once

Infant: 0.05 mg IV slowly once; may repeat at 20 to 30 minute intervals as needed

Uses: For the emergency treatment of allergic reactions (Type I) including anaphylaxis to stinging or biting insects, allergen immunotherapy, foods, drugs, diagnostic testing substances, and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis; and for immediate administration in patients who are determined to be at increased risk for anaphylaxis, including those with a history of anaphylactic reactions.

Warnings

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.

What other drugs will affect Epinephrine injection

Tell your doctor about all your other medicines, especially:

asthma medicine;

an antidepressant;

cold or allergy medicine (Benadryl and others);

heart or blood pressure medicine;

thyroid medication; or

ergot medicine--dihydroergotamine, ergotamine, ergonovine, methylergonovine.

This list is not complete. Other drugs may affect epinephrine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Disclaimer

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