epinephrine indications/contra

Stem definitionDrug idCAS RN
sympathomimetic, phenethyl derivatives 1028 51-43-4

Description:

MoleculeDescription

Molfile Inchi Smiles

Synonyms:

  • epinephrine
  • vasoconstrictine
  • nephridine
  • renoform
  • suprarenin
  • epinephrine bitartrate
  • (-)-adrenaline
  • epinephrine hydrochloride
The active sympathomimetic hormone from the ADRENAL MEDULLA. It stimulates both the alpha- and beta- adrenergic systems, causes systemic VASOCONSTRICTION and gastrointestinal relaxation, stimulates the HEART, and dilates BRONCHI and cerebral vessels. It is used in ASTHMA and CARDIAC FAILURE and to delay absorption of local ANESTHETICS.
  • Molecular weight: 183.21
  • Formula: C9H13NO3
  • CLOGP: -0.68
  • LIPINSKI: 0
  • HAC: 4
  • HDO: 4
  • TPSA: 72.72
  • ALOGS: -0.99
  • ROTB: 3

Drug dosage:

DoseUnitRoute
0.50 mg P
2.24 mg Inhal.aerosol
20 mg Inhal.solution

Approvals:

DateAgencyCompanyOrphan
Nov. 19, 1948 FDA

FDA Adverse Event Reporting System

scroll-->
MedDRA adverse event termLikelihood ratioLikelihood ratio thresholdPatients taking drug having adverse eventPatients taking drug not having adverse eventPatients not taking drug having adverse eventPatients not taking drug not having adverse event
Drug ineffective 2240.86 36.49 955 6338 115135 3263431
Accidental exposure to product 1418.30 36.49 324 6969 4468 3374098
Device failure 1324.36 36.49 273 7020 2228 3376338
Drug hypersensitivity 876.83 36.49 353 6940 35327 3343239
Anaesthetic complication 835.89 36.49 154 7139 631 3377935
Cardiac arrest 803.20 36.49 308 6985 27011 3351555
Stress cardiomyopathy 696.03 36.49 146 7147 1296 3377270
Toxicity to various agents 691.14 36.49 324 6969 46730 3331836
Anaphylactic reaction 686.91 36.49 227 7066 12827 3365739
Hypotension 678.45 36.49 325 6968 49189 3329377
Product quality issue 561.72 36.49 237 7056 26498 3352068
Anaphylactic shock 557.88 36.49 160 7133 5579 3372987
Chondrolysis 531.85 36.49 88 7205 153 3378413
Lagophthalmos 501.36 36.49 77 7216 55 3378511
Toxic anterior segment syndrome 493.52 36.49 93 7200 440 3378126
Bradycardia 474.54 36.49 184 7109 16485 3362081
Tachycardia 411.24 36.49 183 7110 23188 3355378
Seizure 398.93 36.49 213 7080 40187 3338379
Expired product administered 379.76 36.49 93 7200 1726 3376840
Generalised tonic-clonic seizure 355.86 36.49 123 7170 7919 3370647
Overdose 354.64 36.49 186 7107 33792 3344774
Incorrect route of drug administration 350.38 36.49 126 7167 9117 3369449
Ventricular tachycardia 336.15 36.49 109 7184 5753 3372813
Methaemoglobinaemia 308.65 36.49 63 7230 479 3378087
Injection site pallor 304.24 36.49 46 7247 25 3378541
Injury associated with device 293.57 36.49 72 7221 1343 3377223
Loss of consciousness 281.87 36.49 150 7143 27997 3350569
Blood pressure decreased 258.00 36.49 113 7180 13723 3364843
Blood pressure increased 246.80 36.49 127 7166 22103 3356463
Post procedural complication 246.30 36.49 83 7210 4934 3373632

Pharmacologic Action:

scroll-->
SourceCodeDescription
ATC A01AD01 ALIMENTARY TRACT AND METABOLISM
STOMATOLOGICAL PREPARATIONS
STOMATOLOGICAL PREPARATIONS
Other agents for local oral treatment
ATC B02BC09 BLOOD AND BLOOD FORMING ORGANS
ANTIHEMORRHAGICS
VITAMIN K AND OTHER HEMOSTATICS
Local hemostatics
ATC C01CA24 CARDIOVASCULAR SYSTEM
CARDIAC THERAPY
CARDIAC STIMULANTS EXCL. CARDIAC GLYCOSIDES
Adrenergic and dopaminergic agents
ATC R01AA14 RESPIRATORY SYSTEM
NASAL PREPARATIONS
DECONGESTANTS AND OTHER NASAL PREPARATIONS FOR TOPICAL USE
Sympathomimetics, plain
ATC R03AA01 RESPIRATORY SYSTEM
DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES
ADRENERGICS, INHALANTS
Alpha- and beta-adrenoreceptor agonists
ATC S01EA01 SENSORY ORGANS
OPHTHALMOLOGICALS
ANTIGLAUCOMA PREPARATIONS AND MIOTICS
Sympathomimetics in glaucoma therapy1)
ATC R03AK01 RESPIRATORY SYSTEM
DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES
ADRENERGICS, INHALANTS
Adrenergics in combination with corticosteroids or other drugs, excl. anticholinergics
ATC S01EA51 SENSORY ORGANS
OPHTHALMOLOGICALS
ANTIGLAUCOMA PREPARATIONS AND MIOTICS
Sympathomimetics in glaucoma therapy1)
FDA EPC N0000175552 alpha-Adrenergic Agonist
FDA EPC N0000175555 beta-Adrenergic Agonist
FDA EPC N0000175570 Catecholamine
FDA Chemical/Ingredient N0000007715 Catecholamines
MeSH PA D018663 Adrenergic Agents
MeSH PA D000322 Adrenergic Agonists
MeSH PA D000316 Adrenergic alpha-Agonists
MeSH PA D000318 Adrenergic beta-Agonists
MeSH PA D018927 Anti-Asthmatic Agents
MeSH PA D001337 Autonomic Agents
MeSH PA D001993 Bronchodilator Agents
MeSH PA D002317 Cardiovascular Agents
MeSH PA D009184 Mydriatics
MeSH PA D018377 Neurotransmitter Agents
MeSH PA D018373 Peripheral Nervous System Agents
MeSH PA D019141 Respiratory System Agents
MeSH PA D013566 Sympathomimetics
MeSH PA D014662 Vasoconstrictor Agents

Drug Use (View source of the data)

scroll-->
DiseaseRelationSNOMED_IDDOID
Bronchiectasis indication 12295008 DOID:9563
Bronchitis indication 32398004 DOID:6132
Anaphylaxis indication 39579001
Local anesthesia, by infiltration indication 44596000
Low blood pressure indication 45007003
Wheezing indication 56018004
Open-angle glaucoma indication 84494001 DOID:1067
Pulmonary emphysema indication 87433001
Dyspnea indication 267036007
Exacerbation of asthma indication 281239006
Asthma management indication 406162001
Acute exacerbation of asthma indication 708038006
Administration of Local Anesthetic Nerve Block indication
Allergic Reactions indication
Keratitis contraindication 5888003 DOID:4677
Bacterial septicemia contraindication 10001005
Sinus tachycardia contraindication 11092001
Myocardial infarction contraindication 22298006 DOID:5844
Aphakia contraindication 24010005
Complete atrioventricular block contraindication 27885002
Shock contraindication 27942005
Hypovolemia contraindication 28560003
Hypercapnia contraindication 29596007
Parkinsonism contraindication 32798002 DOID:13548
Hyperthyroidism contraindication 34486009 DOID:7998
Hypertensive disorder contraindication 38341003 DOID:10763
Retinal detachment contraindication 42059000 DOID:5327
Hypokalemia contraindication 43339004
Conduction disorder of the heart contraindication 44808001
Stokes-Adams syndrome contraindication 46935006
Chronic heart failure contraindication 48447003
Bradycardia contraindication 48867003
Atrial fibrillation contraindication 49436004 DOID:0060224
Disorder of cardiovascular system contraindication 49601007 DOID:1287
Sinus bradycardia contraindication 49710005
Acute nephropathy contraindication 58574008
Hepatic failure contraindication 59927004
Iritis contraindication 65074000 DOID:1406
Cerebral arteriosclerosis contraindication 65312002
Diabetes mellitus contraindication 73211009 DOID:9351
Wolff-Parkinson-White pattern contraindication 74390002 DOID:384
Decreased respiratory function contraindication 80954004
Cardiogenic shock contraindication 89138009
Kidney disease contraindication 90708001 DOID:2527
Myasthenia gravis contraindication 91637004 DOID:437
Open wound contraindication 125643001
Seizure disorder contraindication 128613002 DOID:1826
Bleeding contraindication 131148009
Angina pectoris contraindication 194828000
Primary dilated cardiomyopathy contraindication 195021004 DOID:12930
Partial atrioventricular block contraindication 195039008
Heart block contraindication 233916004
Disease of liver contraindication 235856003 DOID:409
Sepsis syndrome contraindication 238150007
Benign prostatic hyperplasia contraindication 266569009 DOID:2883
Psychoneurotic personality disorder contraindication 268634009
Deficiency of cholinesterase contraindication 360607009
Hypoxia contraindication 389086002
Angle-closure glaucoma contraindication 392291006 DOID:13550
Peripheral vascular disease contraindication 400047006
Anterior uveitis contraindication 410692006 DOID:1407
Chronic myocardial ischemia contraindication 413844008 DOID:3393
Disorder of coronary artery contraindication 414024009
Denuded skin contraindication 418242004
Thrombosis contraindication 439127006
Occlusive Vascular Disease contraindication
Lidocaine Toxicity contraindication
Regional Anesthesia for Labor Pain contraindication
Reduced Hepatic Blood Flow contraindication
Pupillary Block Glaucoma contraindication
Ventricular fibrillation off-label use 71908006
Asthma off-label use 195967001 DOID:2841
Local anesthesia off-label use 386761002
Cardiac arrest off-label use 410429000 DOID:0060319

Acid dissociation constants calculated using MoKa v3.0.0

scroll-->
Dissociation levelDissociation constantType (acidic/basic)
pKa1 9.97 acidic
pKa2 12.82 acidic
pKa3 13.64 acidic
pKa4 8.71 Basic

Orange Book patent data (new drug applications)

scroll-->
Formulation strengthTrade nameApplicantApplication numberApproval dateTypeDose formRoutePatent numberPatent expiration datePatent use
EQ 0.1MG/DELIVERY AUVI-Q KALEO INC N201739 Nov. 17, 2017 RX SOLUTION INTRAMUSCULAR, SUBCUTANEOUS 9833573 Nov. 23, 2024 METHOD TO TREAT SEVERE ALLERGIC EMERGENCIES IN PATIENTS WEIGHING 7.5 TO 15 KG (16.5 TO 33 LBS)
EQ 0.15MG/DELIVERY AUVI-Q KALEO INC N201739 Aug. 10, 2012 RX SOLUTION INTRAMUSCULAR, SUBCUTANEOUS 9149579 July 19, 2025 METHOD OF TREATING ALLERGIC REACTION VIA INJECTION
EQ 0.1MG/DELIVERY AUVI-Q KALEO INC N201739 Nov. 17, 2017 RX SOLUTION INTRAMUSCULAR, SUBCUTANEOUS 9149579 July 19, 2025 METHOD OF TREATING ALLERGIC REACTION VIA INJECTION
EQ 0.3MG/DELIVERY AUVI-Q KALEO INC N201739 Aug. 10, 2012 RX SOLUTION INTRAMUSCULAR, SUBCUTANEOUS 9149579 July 19, 2025 METHOD OF TREATING ALLERGIC REACTION VIA INJECTION
EQ 0.15MG/DELIVERY AUVI-Q KALEO INC N201739 Aug. 10, 2012 RX SOLUTION INTRAMUSCULAR, SUBCUTANEOUS 9724471 May 23, 2027 METHOD FOR CONFIRMING DOSE DELIVERY
EQ 0.1MG/DELIVERY AUVI-Q KALEO INC N201739 Nov. 17, 2017 RX SOLUTION INTRAMUSCULAR, SUBCUTANEOUS 9724471 May 23, 2027 METHOD FOR CONFIRMING DOSE DELIVERY
EQ 0.3MG/DELIVERY AUVI-Q KALEO INC N201739 Aug. 10, 2012 RX SOLUTION INTRAMUSCULAR, SUBCUTANEOUS 9724471 May 23, 2027 METHOD FOR CONFIRMING DOSE DELIVERY
EQ 1MG BASE/ML (EQ 1MG BASE/ML) EPINEPHRINE BELCHER PHARMS LLC N205029 July 29, 2014 RX SOLUTION IV (INFUSION), INTRAOCULAR, INTRAMUSCULAR, SUBCUTANEOUS 9283197 Aug. 15, 2034 EMERGENCY TREATMENT OF ALLERGIC REACTIONS (TYPE I), INCLUDING ANAPHYLAXIS
EQ 1MG BASE/ML (EQ 1MG BASE/ML) EPINEPHRINE BELCHER PHARMS LLC N205029 July 29, 2014 RX SOLUTION IV (INFUSION), INTRAOCULAR, INTRAMUSCULAR, SUBCUTANEOUS 9283197 Aug. 15, 2034 INCREASING MEAN ARTERIAL BLOOD PRESSURE IN ADULT PATIENTS WITH HYPOTENSION ASSOCIATED WITH SEPTIC SHOCK
EQ 1MG BASE/ML (EQ 1MG BASE/ML) EPINEPHRINE BELCHER PHARMS LLC N205029 July 29, 2014 RX SOLUTION IV (INFUSION), INTRAOCULAR, INTRAMUSCULAR, SUBCUTANEOUS 9283197 Aug. 15, 2034 INDUCTION AND MAINTENANCE OF MYDRIASIS DURING INTRAOCULAR SURGERY
EQ 1MG BASE/ML (EQ 1MG BASE/ML) ADRENALIN PAR STERILE PRODUCTS N204200 Dec. 7, 2012 RX SOLUTION INTRAMUSCULAR, SUBCUTANEOUS 9295657 March 13, 2035 EMERGENCY TREATMENT OF ALLERGIC REACTIONS (TYPE I), INCLUDING ANAPHYLAXIS
EQ 30MG BASE/30ML (EQ 1MG BASE/ML) ADRENALIN PAR STERILE PRODUCTS N204640 Dec. 18, 2013 RX SOLUTION INTRAMUSCULAR, SUBCUTANEOUS 9295657 March 13, 2035 EMERGENCY TREATMENT OF ALLERGIC REACTIONS (TYPE I), INCLUDING ANAPHYLAXIS

Orange Book exclusivity data (new drug applications)

None

Bioactivity Summary:

scroll-->
TargetClassPharosUniProtActionTypeActivity value
(-log[M])
Mechanism
action
Bioact sourceMoA source
Alpha-1B adrenergic receptor GPCR AGONIST UNKNOWN CHEMBL
Alpha-2A adrenergic receptor GPCR AGONIST Ki 6.56 DRUG MATRIX CHEMBL
Alpha-1A adrenergic receptor GPCR AGONIST Ki 5.70 CHEMBL CHEMBL
Alpha-2B adrenergic receptor GPCR AGONIST Ki 6.40 DRUG MATRIX CHEMBL
Alpha-2C adrenergic receptor GPCR AGONIST Ki 6.45 DRUG MATRIX CHEMBL
Beta-2 adrenergic receptor GPCR AGONIST Kd 6.20 CHEMBL CHEMBL
Alpha-1D adrenergic receptor GPCR AGONIST UNKNOWN CHEMBL
Sodium-dependent noradrenaline transporter Transporter Ki 5.43 PDSP
Beta-1 adrenergic receptor GPCR Ki 5.40 PDSP
D(1A) dopamine receptor GPCR Kd 4.26 CHEMBL
Mu-type opioid receptor GPCR Ki 5.40 CHEMBL
Beta-1 adrenergic receptor GPCR Ki 5.96 CHEMBL
Beta-2 adrenergic receptor GPCR Ki 6.14 CHEMBL
Beta-1 adrenergic receptor GPCR Ki 5.52 CHEMBL
Alpha-1A adrenergic receptor GPCR IC50 6.20 CHEMBL
M18 aspartyl aminopeptidase Unclassified IC50 5.52 CHEMBL
Arachidonate 15-lipoxygenase Enzyme IC50 5.48 DRUG MATRIX
Alpha-1B adrenergic receptor GPCR Ki 6.01 DRUG MATRIX
Adrenergic receptor alpha-2 GPCR Ki 7.89 CHEMBL
Beta-2 adrenergic receptor GPCR Ki 6.18 CHEMBL
Adrenergic receptor beta GPCR IC50 4.54 CHEMBL

External reference:

scroll-->
IDSource
CHEBI:6213 CHEBI
4018034 VUID
N0000146377 NUI
C0014563 UMLSCUI
D00996 KEGG_DRUG
CHEMBL679 ChEMBL_ID
30Q7KI53AK UNII
51-42-3 SECONDARY_CAS_RN
DB00668 DRUGBANK_ID
3451 MMSL
3992 RXNORM
387362001 SNOMEDCT_US
4663 MMSL
4018034 VANDF
65502005 SNOMEDCT_US
N0000006261 NDFRT
N0000146377 NDFRT
d00699 MMSL
001774 NDDF
CHEMBL1256958 ChEMBL_ID
D004837 MESH_DESCRIPTOR_UI
CHEMBL3183376 ChEMBL_ID
2142 INN_ID
5816 PUBCHEM_CID
ALE PDB_CHEM_ID

Pharmaceutical products:

scroll-->
ProductCategoryIngredientsNDCFormQuantityRoute MarketingLabel
epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0115-1694 INJECTION 0.30 mg SUBCUTANEOUS NDA AUTHORIZED GENERIC 18 sections
epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0115-1695 INJECTION 0.15 mg SUBCUTANEOUS NDA AUTHORIZED GENERIC 18 sections
Lignospan Standard HUMAN PRESCRIPTION DRUG LABEL 1 0362-1095 INJECTION, SOLUTION 0.01 mg SUBCUTANEOUS ANDA 12 sections
Lignospan Forte HUMAN PRESCRIPTION DRUG LABEL 1 0362-1096 INJECTION, SOLUTION 0.02 mg SUBCUTANEOUS ANDA 12 sections
Octocaine 50 HUMAN PRESCRIPTION DRUG LABEL 2 0362-9010 INJECTION, SOLUTION 0.02 mg SUBCUTANEOUS ANDA 12 sections
Vivacaine HUMAN PRESCRIPTION DRUG LABEL 2 0362-9011 INJECTION, SOLUTION 0.01 mg SUBCUTANEOUS ANDA 11 sections
Prilocaine Hydrochloride with Epinephrine HUMAN PRESCRIPTION DRUG LABEL 2 0362-9013 INJECTION, SOLUTION 0.01 mg SUBCUTANEOUS ANDA 12 sections
Octocaine 100 HUMAN PRESCRIPTION DRUG LABEL 2 0362-9023 INJECTION, SOLUTION 0.01 mg SUBCUTANEOUS ANDA 12 sections
Septocaine and Epinephrine HUMAN PRESCRIPTION DRUG LABEL 2 0362-9048 INJECTION, SOLUTION 0.01 mg SUBCUTANEOUS NDA 18 sections
Septocaine and Epinephrine HUMAN PRESCRIPTION DRUG LABEL 2 0362-9049 INJECTION, SOLUTION 0.01 mg SUBCUTANEOUS NDA 18 sections
LIDOCAINE HUMAN PRESCRIPTION DRUG LABEL 1 0404-6500 INJECTION, SOLUTION 0.02 mg SUBCUTANEOUS ANDA 12 sections
Lidocaine HUMAN PRESCRIPTION DRUG LABEL 1 0404-6512 INJECTION, SOLUTION 0.01 mg SUBCUTANEOUS ANDA 12 sections
Articaine Hydrochloride and Epinephrine HUMAN PRESCRIPTION DRUG LABEL 2 0404-6620 INJECTION, SOLUTION 0.01 mg SUBCUTANEOUS NDA 18 sections
Articaine Hydrochloride and Epinephrine HUMAN PRESCRIPTION DRUG LABEL 2 0404-6625 INJECTION, SOLUTION 0.01 mg SUBCUTANEOUS NDA 18 sections
Lidocaine Hydrochloride and Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-1209 INJECTION, SOLUTION 5 ug EPIDURAL ANDA 12 sections
Marcaine with Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-1746 INJECTION, SOLUTION 0.01 mg INFILTRATION NDA 12 sections
Marcaine with Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-1749 INJECTION, SOLUTION 0.01 mg EPIDURAL NDA 12 sections
Marcaine with Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-1752 INJECTION, SOLUTION 0.01 mg INFILTRATION NDA 12 sections
Marcaine with Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-1755 INJECTION, SOLUTION 0.01 mg PERINEURAL NDA 12 sections
Lidocaine Hydrochloride and Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-3177 INJECTION, SOLUTION 5 ug INFILTRATION ANDA 12 sections
Lidocaine Hydrochloride and Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-3178 INJECTION, SOLUTION 10 ug INFILTRATION ANDA 12 sections
Lidocaine Hydrochloride and Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-3181 INJECTION, SOLUTION 5 ug EPIDURAL ANDA 12 sections
Lidocaine Hydrochloride and Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-3182 INJECTION, SOLUTION 10 ug INFILTRATION ANDA 12 sections
Lidocaine Hydrochloride and Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-3183 INJECTION, SOLUTION 5 ug EPIDURAL ANDA 12 sections
Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-4901 INJECTION, SOLUTION 0.10 mg INTRAVENOUS UNAPPROVED DRUG OTHER 12 sections
Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-4921 INJECTION, SOLUTION 0.10 mg INTRAVENOUS UNAPPROVED DRUG OTHER 12 sections
Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-7241 INJECTION, SOLUTION 1 mg SUBCUTANEOUS Unapproved drug other 12 sections
BUPIVACAINE HYDROCHLORIDE AND EPINEPHRINE HUMAN PRESCRIPTION DRUG LABEL 1 0409-9042 INJECTION, SOLUTION 5 ug INFILTRATION ANDA 12 sections
Bupivacaine Hydrochloride and Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-9043 INJECTION, SOLUTION 5 ug INFILTRATION ANDA 12 sections
Bupivacaine Hydrochloride and Epinephrine HUMAN PRESCRIPTION DRUG LABEL 1 0409-9045 INJECTION, SOLUTION 5 ug EPIDURAL ANDA 12 sections