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Drug overview for ADRENALIN CHLORIDE (epinephrine hcl):
Generic name: EPINEPHRINE HCL
Drug class: Nasal Decongestants
Therapeutic class: Respiratory Therapy Agents
Epinephrine, an endogenous catecholamine that is the active principle of the adrenal medulla, is a vasoconstrictor.
Epinephrine is used locally to control superficial bleeding from arterioles and capillaries in the skin and mucous membranes of the eye, nose, mouth, throat or larynx, mainly during surgery. Bleeding from larger vessels is not controllable by topical application of epinephrine. The drug is especially useful in dental surgery.
Epinephrine may be added to solutions of some local anesthetics such as procaine or lidocaine to decrease the rate of vascular absorption of the local anesthetic, thereby localizing anesthesia and prolonging the duration of anesthesia; the risk of systemic toxicity caused by the local anesthetic is also decreased, and bleeding in the operative field may be reduced. Epinephrine may be applied topically to the nasal mucosa as a decongestant; however, the drug has a short duration of action and rebound congestion frequently occurs. Other longer acting sympathomimetic agents such as oxymetazoline are more commonly used for this purpose.
Epinephrine has been used as a decongestant when applied topically to the conjunctiva in patients with conjunctivitis resulting from nonspecific chronic irritation or allergy. However, the drug's effects in such cases usually lasted less than 1 hour and may have been followed by reactive hyperemia. For systemic uses of epinephrine, see Epinephrine 12:12.12. For uses of epinephrine in the treatment of glaucoma or as a mydriatic,see Epinephrine 52:24.
Generic name: EPINEPHRINE HCL
Drug class: Nasal Decongestants
Therapeutic class: Respiratory Therapy Agents
Epinephrine, an endogenous catecholamine that is the active principle of the adrenal medulla, is a vasoconstrictor.
Epinephrine is used locally to control superficial bleeding from arterioles and capillaries in the skin and mucous membranes of the eye, nose, mouth, throat or larynx, mainly during surgery. Bleeding from larger vessels is not controllable by topical application of epinephrine. The drug is especially useful in dental surgery.
Epinephrine may be added to solutions of some local anesthetics such as procaine or lidocaine to decrease the rate of vascular absorption of the local anesthetic, thereby localizing anesthesia and prolonging the duration of anesthesia; the risk of systemic toxicity caused by the local anesthetic is also decreased, and bleeding in the operative field may be reduced. Epinephrine may be applied topically to the nasal mucosa as a decongestant; however, the drug has a short duration of action and rebound congestion frequently occurs. Other longer acting sympathomimetic agents such as oxymetazoline are more commonly used for this purpose.
Epinephrine has been used as a decongestant when applied topically to the conjunctiva in patients with conjunctivitis resulting from nonspecific chronic irritation or allergy. However, the drug's effects in such cases usually lasted less than 1 hour and may have been followed by reactive hyperemia. For systemic uses of epinephrine, see Epinephrine 12:12.12. For uses of epinephrine in the treatment of glaucoma or as a mydriatic,see Epinephrine 52:24.
DRUG IMAGES
ADRENALIN 1 MG/ML NASAL SOLN
The following indications for ADRENALIN CHLORIDE (epinephrine hcl) have been approved by the FDA:
Indications:
None.
Professional Synonyms:
None.
Indications:
None.
Professional Synonyms:
None.
The following dosing information is available for ADRENALIN CHLORIDE (epinephrine hcl):
Dosage of epinephrine hydrochloride is expressed in terms of epinephrine.
As a vasoconstrictor to control bleeding in the mucosa or to produce nasal decongestion, a 0.1% (1:1000) solution of epinephrine is applied topically as drops or spray to mucosa as required. To control bleeding during ocular surgery or to produce conjunctival decongestion, 1 or more drops of a 0.1%
(1:1000) solution of epinephrine (no longer commercially available in the US) has been applied topically to the conjunctiva 1-3 times or as necessary. To control ocular bleeding, the drug may be injected into the anterior chamber of the eye or subconjunctivally in concentrations of 0.01% (1:10,000) to 0.1%
(1:1000). As a topical hemostatic, solutions containing epinephrine in concentrations of 0.002% (1:50,000) to 0.1%
(1:1000) may be sprayed or applied with cotton or gauze to the skin, mucous membranes, or other tissues. In one study, 4 mL of a 0.0005% (1:200,000) solution of epinephrine was infiltrated into the buccal and labial vestibules of the maxilla and mandible in each quadrant as a hemostatic in oral surgery.
For use with local anesthetics, epinephrine may be used in concentrations of 0.0005% (1:200,000) to 0.002% (1:50,000).
As a vasoconstrictor to control bleeding in the mucosa or to produce nasal decongestion, a 0.1% (1:1000) solution of epinephrine is applied topically as drops or spray to mucosa as required. To control bleeding during ocular surgery or to produce conjunctival decongestion, 1 or more drops of a 0.1%
(1:1000) solution of epinephrine (no longer commercially available in the US) has been applied topically to the conjunctiva 1-3 times or as necessary. To control ocular bleeding, the drug may be injected into the anterior chamber of the eye or subconjunctivally in concentrations of 0.01% (1:10,000) to 0.1%
(1:1000). As a topical hemostatic, solutions containing epinephrine in concentrations of 0.002% (1:50,000) to 0.1%
(1:1000) may be sprayed or applied with cotton or gauze to the skin, mucous membranes, or other tissues. In one study, 4 mL of a 0.0005% (1:200,000) solution of epinephrine was infiltrated into the buccal and labial vestibules of the maxilla and mandible in each quadrant as a hemostatic in oral surgery.
For use with local anesthetics, epinephrine may be used in concentrations of 0.0005% (1:200,000) to 0.002% (1:50,000).
Epinephrine solutions are applied topically to mucous membranes. The drug may also be injected intracamerally (into the anterior chamber of the eye) or subconjunctivally (beneath Tenon's capsule) to control hemorrhage. Epinephrine nasal and topical solutions must not be injected.
No dosing information available.
No generic dosing information available.
The following drug interaction information is available for ADRENALIN CHLORIDE (epinephrine hcl):
There are 0 contraindications.
There are 4 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Epinephrine/Non-Cardioselective Beta-Blockers SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Concurrent use of beta-blockers also block the beta effects of epinephrine, which results in predomination of alpha effects. The plasma clearance of epinephrine is decreased. CLINICAL EFFECTS: Concurrent use of epinephrine with beta-blockers may result in hypertension with reflex bradycardia. Epinephrine resistance in patients with anaphylaxis has been reported. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Avoid concomitant administration of epinephrine and beta-blockers if possible. If both drugs are administered, monitor blood pressure carefully. Hypertension and bradycardia are less likely to occur with cardioselective beta-blockers. Use caution when treating anaphylaxis with epinephrine since response may be poor. DISCUSSION: In a study of 6 subjects, an increase in mean arterial pressure (MAP) of 15.1% (p < 0.05) was observed after an infusion of epinephrine (10 ng/kg/min) followed by an intravenous injection of propranolol (40 mcg/kg). In addition, plasma clearance of epinephrine decreased to 54.7% of the control value after the dose of propranolol.(1) In another study of 6 subjects, patients were intravenously administered 15 mcg epinephrine, followed by propranolol 0.04 mg/kg, and then another dose of epinephrine. A mean decrease in heart rate of 37% (p < 0.001) was observed following the second dose of epinephrine.(2) In a study in 10 healthy subjects, an increase in MAP was observed after infusion of epinephrine (5 mcg/min) followed by infusion of propranolol (10 mg).(5) In a study in 1 healthy subject, marked bradycardia and atrioventricular block occurred after administration of propranolol (40 mg orally) with epinephrine (17 mcg/min intravenously).(6) In a study in 7 healthy subjects, and increase in MAP (8% increase in systolic blood pressure, 10% increase in diastolic blood pressure) was observed after injection of epinephrine (45 mcg in lidocaine) in to the maxilla after pretreatment with pindolol (5 mg).(7) A retrospective analysis of sinus surgery patients found that 9.1% had exaggerated intraoperative hypertensive events during the first surgical hour (defined as relative increase greater than 20% of systolic blood pressure or single systolic blood pressure value above 200 mmHg). Subjects with established beta blockade were found to be three times as likely to experience an exaggerated hypertensive event during the first intraoperative hour.(8) In a study, intraoral injection with 2% lidocaine containing epinephrine (45 mcg) after pretreatment with pindolol (5 mg) resulted reduced stroke volume, increase in afterload, decreased myocardial contractility, decreased heart rate, and an increase in blood pressure.(9) In a study in 8 subjects, a comparison of propranolol (80 mg three times daily) or metoprolol (100 mg three times daily) with epinephrine (8 mcg/min for 6 minutes) showed that propranolol significantly increases MAP while metoprolol, a beta1-selective beta-blocker, does not.(10) There are several case reports of significant hypertension with reflex bradycardia.(9-12) In some of these case reports patients had strokes.(12) |
BETAPACE, BETAPACE AF, CORGARD, HEMANGEOL, INDERAL LA, INDERAL XL, INNOPRAN XL, LABETALOL HCL, LABETALOL HCL-WATER, NADOLOL, PINDOLOL, PROPRANOLOL HCL, PROPRANOLOL HCL ER, PROPRANOLOL-HYDROCHLOROTHIAZID, SOTALOL, SOTALOL AF, SOTALOL HCL, SOTYLIZE, TIMOLOL MALEATE |
| Ergot Alkaloids/Sympathomimetics SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Concurrent use of ergot alkaloids and sympathomimetics may result in additive or synergistic effect on peripheral blood vessels. CLINICAL EFFECTS: Concurrent use of ergot alkaloids and sympathomimetics may result in increased blood pressure due to peripheral vasoconstriction. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: When possible, avoid the concurrent use of ergot alkaloids and sympathomimetics. If concurrent use is warranted, monitor blood pressure and for signs of vasoconstriction. Decreasing the dose of one or both drugs may be necessary. DISCUSSION: There have been reports of severe vasoconstriction resulting in gangrene in patients receiving intravenous ergonovine with dopamine or norepinephrine. |
DIHYDROERGOTAMINE MESYLATE, ERGOLOID MESYLATES, ERGOMAR, ERGOTAMINE TARTRATE, ERGOTAMINE-CAFFEINE, METHYLERGONOVINE MALEATE, METHYSERGIDE MALEATE, MIGERGOT, MIGRANAL, TRUDHESA |
| Selected Inhalation Anesthetic Agents/Sympathomimetics SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: The exact mechanism is unknown. The anesthetics produce conduction changes that increase impulse re-entry into the myocardial tissue.(1) The anesthetics' ability to precipitate arrhythmias is enhanced by elevated arterial blood pressure, tachycardia, hypercapnia, and/or hypoxia, events that stimulate the release of endogenous catecholamines.(1) CLINICAL EFFECTS: Concurrent use of inhalation anesthetic agents and sympathomimetics may result in ventricular arrhythmias or sudden blood pressure and heart rate increase during surgery.(2) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Monitor blood pressure and avoid use of sympathomimetics in patients being treated with anesthetics on the day of surgery.(2) Intravenous use of epinephrine during surgery with halothane and related halogenated general anesthetics should be strongly discouraged. When intravenous epinephrine is necessary, nitrous oxide anesthesia supplemented with ether, muscle relaxants, or opioids should be used instead of halothane.(3,4) Epinephrine may safely be used subcutaneously with the following precautions: the patient is adequately ventilated to prevent hypoxia or respiratory acidosis; the total dose of epinephrine is limited to 100 mcg/10 minute period or 300 mcg/hour in adults, 3.5 mcg/Kg in infants, 2.5 mcg/Kg in children up to two years of age, and 1.45 mcg/Kg in children over two years of age; a minimum effective concentration of anesthetic is maintained; the drugs are not co-administered in patients with hypertension or other cardiovascular disorders; and the cardiac rhythm is continuously monitored during and after injection.(3-10) If arrhythmias occur after the administration of the epinephrine, the drugs of choice are lidocaine or propranolol, depending on the type of arrhythmia.(1) DISCUSSION: Administration of epinephrine during halothane anesthesia may may lead to serious ventricular arrhythmias.(3-6,11-18) This has occurred when epinephrine was administered intravenously,(6) when it was administered with lidocaine as a dental block,(11,14) or when it was administered supraperiosteally.(5) Norepinephrine has been shown to interact with halothane in a manner similar to epinephrine.(1) In two case reports, patients were given terbutaline (0.25 to 0.35 mg) for wheezing following induction of anesthesia with halothane. One patient's heart rate increased from 68 to 100 beats/minute, and the ECG showed premature ventricular contractions and bigeminy, while the other patient developed multiple unifocal premature ventricular contractions and bigeminy. The arrhythmias resolved in both patients following lidocaine administration.(19) Although not documented, isoproterenol causes effects on the heart similar to terbutaline(20) and would probably interact with halothane in a similar manner. Other inhalation anesthetics that increase the incidence of arrhythmias with epinephrine include chloroform,(20) methoxyflurane,(20) and enflurane.(12) A similar interaction may be expected between the other inhalation anesthetics and sympathomimetics. |
DESFLURANE, FORANE, ISOFLURANE, SEVOFLURANE, SUPRANE, TERRELL, ULTANE |
| Iobenguane I 123/Agents that Affect Catecholamines SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Many compounds that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells.(1) CLINICAL EFFECTS: Compounds that reduce catecholamine uptake or that deplete catecholamine stores may interfere with imaging completed with iobenguane.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Discuss the use of agents that affect catecholamines. Discontinue drugs that reduce catecholamine uptake or deplete catecholamine stores prior to imaging with iobenguane. Before imaging with iobenguane, discontinue agents that affect catecholamines for at least 5 biological half-lives, as clinically tolerated.(1) DISCUSSION: Many agents may reduce catecholamine uptake or deplete catecholamine stores.(1) Examples include: - CNS stimulants or amphetamines (e.g. cocaine, methylphenidate, dextroamphetamine) - norepinephrine and dopamine reuptake inhibitors (e.g. phentermine) - norepinephrine and serotonin reuptake inhibitors (e.g. tramadol) - monoamine oxidase inhibitors (e.g. phenelzine, linezolid) - central monoamine depleting drugs (e.g. reserpine) - non-select beta adrenergic blocking drugs (e.g. labetalol) - alpha agonists or alpha/beta agonists (e.g. pseudoephedrine, phenylephrine, ephedrine, phenylpropanolamine, naphazoline) - tricyclic antidepressants or norepinephrine reuptake inhibitors (e.g. amitriptyline, bupropion, duloxetine, mirtazapine, venlafaxine) - botanicals that may inhibit reuptake of norepinephrine, serotonin or dopamine (e.g. ephedra, ma huang, St. John's Wort, yohimbine) |
ADREVIEW |
There are 5 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| Sympathomimetics (Direct, Mixed-Acting)/Guanethidine SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Direct or mixed-acting sympathomimetics may inhibit uptake of guanethidine at the adrenergic neuron. CLINICAL EFFECTS: Decreased antihypertensive effectiveness. Effects may be seen for several days after discontinuation of the direct or mixed-acting sympathomimetic. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Avoid concomitant administration of these drugs. If both drugs are administered, adjust the guanethidine dose as needed based on blood pressure. DISCUSSION: Documentation supports routine monitoring of this interaction. It should be noted that this interaction can occur quickly. |
GUANETHIDINE HEMISULFATE |
| Sympathomimetics/Rauwolfia Alkaloids SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Reserpine depletes catecholamine stores within the peripheral vascular adrenergic nerve endings, thus indirect acting sympathomimetics are unable to trigger the release of catecholamines. The reserpine-induced catecholamine release increases sensitivity to the effects of direct acting sympathomimetics. CLINICAL EFFECTS: Increased effects of direct acting sympathomimetics. Decreased effects of indirect acting sympathomimetics. Mixed acting sympathomimetics will show effects based on the predominance of either direct or indirect activity. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: If these agents are administered concurrently, monitor blood pressure. The dose of the sympathomimetic may need to be adjusted. DISCUSSION: This interaction has been well documented in animal studies and human case reports have confirmed the interaction. Reserpine has been shown to decrease the response to epinephrine administered for hypotension. Reserpine has also been shown to decrease the effectiveness of ophthalmic epinephrine, a direct acting sympathomimetic. Ophthalmic phenylephrine has been shown to decrease the hypotensive effects of reserpine. |
RESERPINE |
| Entacapone; Opicapone/COMT-Metabolized Agents SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Entacapone and opicapone are selective and reversible inhibitors of catechol-O-methyltransferase (COMT) and drugs that are metabolized by COMT can not be fully metabolized when given with entacapone or opicapone.(1) CLINICAL EFFECTS: COMT-metabolized agents can interact with entacapone or opicapone and may result in an increased heart rates, arrhythmias, or an excessive change in blood pressure.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The manufacturers of entacapone and opicapone recommend using caution when administering entacapone or opicapone and a COMT-metabolized agent regardless of the route of administration (including inhalation).(1-3) DISCUSSION: In an interaction study, ventricular tachycardia was observed after epinephrine and entacapone administration.(1) Another study on the effect of entacapone given with isoproterenol and epinephrine concluded that entacapone may potentiate the chronotropic and arrhythmogenic effects of isoproterenol and epinephrine.(4) |
CARBIDOPA-LEVODOPA-ENTACAPONE, ENTACAPONE, ONGENTYS |
| Epinephrine/Cardioselective Beta-Blockers SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Concurrent use of beta-blockers also block the beta effects of epinephrine, which results in predomination of alpha effects. The plasma clearance of epinephrine is decreased. CLINICAL EFFECTS: Concurrent use of epinephrine with beta-blockers may result in hypertension with reflex bradycardia. Epinephrine resistance in patients with anaphylaxis has been reported. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Hypertension and bradycardia are less likely to occur with cardioselective beta-blockers. If both drugs are administered, monitor blood pressure carefully. Use caution when treating anaphylaxis with epinephrine since response may be poor. DISCUSSION: A 29-year-old male undergoing elective nasal septoplasty developed severe hypertension with a blood pressure of 207/123 mmHg after topical epinephrine (1:1000) was applied to the nasal mucosa. Intravenous metoprolol was administered but the patient went into cardiogenic shock thought to be a result of unopposed alpha stimulation by the combination of epinephrine and metoprolol.(1) A study observed the differences in cardiovascular responses to subcutaneous epinephrine (given to provide hemostasis during scalp incision for craniotomy) between patients who received propranolol vs. metoprolol vs. no pretreatment. While metoprolol prevented the cardiovascular effects of epinephrine infiltration, propranolol pretreatment was associated with a highly significant increase (P less than 0.01) in mean arterial pressure and a significant decrease (P less than 0.05) in heart rate.(2) A double-blind cross-over trial studied the effects of epinephrine infusion during treatment with propranolol vs. metoprolol in 8 hypertensive patients. Patients on propranolol experienced significant increases in blood pressure and systemic vascular resistance (SVR), whereas patients on metoprolol had less increase in systolic blood pressure while the diastolic pressure remained unchanged and SVR decreased.(3) In spontaneously hypertensive rats, epinephrine in combination with pindolol induced remarkable hemodynamic changes (in particular, increase in diastolic blood pressure), which were prevented by phentolamine pretreatment, whereas epinephrine with acebutolol pretreatment induced no significant hemodynamic changes.(4) |
ACEBUTOLOL HCL, ATENOLOL, ATENOLOL-CHLORTHALIDONE, BETAXOLOL HCL, BISOPROLOL FUMARATE, BISOPROLOL-HYDROCHLOROTHIAZIDE, BREVIBLOC, BYSTOLIC, CARVEDILOL, CARVEDILOL ER, COREG, COREG CR, ESMOLOL HCL, ESMOLOL HCL-SODIUM CHLORIDE, ESMOLOL HCL-WATER, KAPSPARGO SPRINKLE, LOPRESSOR, METOPROLOL SUCCINATE, METOPROLOL TARTRATE, METOPROLOL-HYDROCHLOROTHIAZIDE, NEBIVOLOL HCL, RAPIBLYK, TENORETIC 100, TENORETIC 50, TENORMIN, TOPROL XL |
| Zavegepant/Intranasal Decongestants SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Intranasal decongestants may decrease the absorption of zavegepant.(1) CLINICAL EFFECTS: Concurrent administration of intranasal decongestants may result in decreased systemic exposure and effectiveness of zavegepant.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Avoid concurrent use of intranasal decongestants with zavegepant. If concurrent use is unavoidable, use the decongestant at least 1 hour after zavegepant.(1) DISCUSSION: Intranasal decongestants may lower absorption of zavegepant. This effect has not been clinically evaluated.(1) |
ZAVZPRET |
The following contraindication information is available for ADRENALIN CHLORIDE (epinephrine hcl):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 1 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Angle-closure glaucoma |
There are 4 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Cardiac arrhythmia |
| Congenital long QT syndrome |
| Coronary artery disease |
| Psychoneurotic personality disorder |
There are 7 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Aphakia |
| Cerebral arteriosclerosis |
| Diabetes mellitus |
| Hypertension |
| Hyperthyroidism |
| Kidney disease with reduction in glomerular filtration rate (GFr) |
| Parkinsonism |
The following adverse reaction information is available for ADRENALIN CHLORIDE (epinephrine hcl):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 6 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. | None. |
| Rare/Very Rare |
|---|
|
Cardiac arrhythmia Hyperhidrosis Insomnia Nervousness Pallor Tachycardia |
There are 25 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Fatigue Headache disorder Nasal passage irritation Paresthesia Pharyngitis Rhinorrhea Sneezing |
Acute abdominal pain Acute cognitive impairment Angina Bronchial congestion Dizziness Dry nose Dry throat Epistaxis General weakness Gingival pain Hypertension Nausea Oral hypoesthesia Palpitations Rebound nasal congestion Symptoms of anxiety Tremor Vomiting |
| Rare/Very Rare |
|---|
| None. |
The following precautions are available for ADRENALIN CHLORIDE (epinephrine hcl):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
Although there are no adequate and controlled studies to date in humans, epinephrine has been shown to be teratogenic in rats when given at dosages 25 times the usual human dosage. Parenterally administered epinephrine in late pregnancy or labor may cause fetal anoxia. (See Cautions: Pregnancy, in Epinephrine 12:12.12.) Epinephrine should be used during pregnancy only when the potential benefits justify the possible risks to the fetus.
No enhanced Lactation information available for this drug.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for ADRENALIN CHLORIDE (epinephrine hcl):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for ADRENALIN CHLORIDE (epinephrine hcl)'s list of indications:
No ICD codes found for this drug.
No ICD codes found for this drug.
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