Epinephrine 1mg/ml Inj, 1ml

Epinephrine is a sympathomimetic catecholamine that acts on alpha-1, beta-1, and beta-2 adrenergic receptors. Its alpha-1 effects cause vasoconstriction, increasing peripheral vascular resistance and blood pressure. Beta-1 effects increase heart rate, myocardial contractility, and cardiac output. Beta-2 effects cause bronchodilation and mast cell stabilization, inhibiting the release of mediators of immediate hypersensitivity.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat
Signs of low potassium levels: muscle pain or weakness, muscle cramps, or an abnormal heartbeat
Signs of high blood pressure: severe headache or dizziness, fainting, or changes in vision
Chest pain or pressure
Rapid heartbeat
Shortness of breath
Urination problems (inability to pass urine or changes in urine output)
Abnormal sensations: burning, numbness, or tingling
Weakness on one side of the body, trouble speaking or thinking, balance problems, drooping on one side of the face, or blurred vision
Severe abnormal heartbeat (which can be life-threatening, especially if you have pre-existing heart problems or take certain medications)

If you experience an abnormal heartbeat, contact your doctor immediately.

Additional Warnings for Allergic Reactions

In rare cases, infections can occur at the injection site. If you notice any signs of infection, such as persistent redness, warmth, swelling, or tenderness, contact your doctor right away.

Injection-Related Warnings

If this medication is administered intravenously, it can cause tissue damage if it leaks from the vein. Inform your nurse immediately if you experience any of the following symptoms at the injection site: redness, burning, pain, swelling, blisters, skin sores, or fluid leakage.

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to contact your doctor or seek medical help if you're bothered by any of the following symptoms or if they persist:

Anxiety, nervousness, excitability, shakiness, or restlessness
Upset stomach or vomiting
Excessive sweating
Pale skin
Headache
Dizziness, tiredness, or weakness
* Goosebumps

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have to this medication, its components, or other substances, including foods and drugs. Be sure to describe the allergic reaction you experienced, including the symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is not an exhaustive list, and it is crucial to discuss all your medications and health conditions with your doctor and pharmacist to ensure safe use.
Any health problems you have, as they may interact with this medication. Your doctor and pharmacist need to be aware of all your medications and health issues to verify that it is safe for you to take this medication.
Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor. This includes all prescription and OTC medications, as well as any changes to your treatment regimen.

Important Warnings and Cautions

When taking this medication, it is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are using this drug.

Administration Precautions
Do not administer this medication into the fingers, hands, or feet, as this may cause reduced blood flow to these areas. If accidental administration occurs, seek immediate medical attention.

Allergy Considerations
If you have a sulfite allergy, consult your doctor before using this medication, as some products may contain sulfites.

Diabetes Management
If you have high blood sugar (diabetes), closely monitor your blood sugar levels while taking this medication.

Geriatric Use
If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.

Pregnancy and Breastfeeding
If you are pregnant, plan to become pregnant, or are breastfeeding, discuss the benefits and risks of this medication with your doctor to ensure the best outcome for you and your baby.

Ophthalmic Use
When using this medication in the eye, you may experience sensitivity to bright lights. To minimize discomfort, wear sunglasses.

• Beta-adrenergic blockers (non-selective): May antagonize the beta-adrenergic effects of epinephrine, leading to unopposed alpha-adrenergic effects (severe hypertension, reflex bradycardia).
• Alpha-adrenergic blockers: May antagonize the alpha-adrenergic effects of epinephrine, leading to hypotension and tachycardia.
• Cocaine: Potentiates the effects of epinephrine, leading to severe hypertension and arrhythmias.
• Tricyclic antidepressants (TCAs): May potentiate the pressor effects of epinephrine, leading to severe hypertension and arrhythmias.
• Monoamine oxidase inhibitors (MAOIs): May potentiate the pressor effects of epinephrine, leading to hypertensive crisis.
• General anesthetics (e.g., halogenated hydrocarbons like halothane): May sensitize the myocardium to the effects of epinephrine, increasing risk of arrhythmias.

• Digoxin: Increased risk of arrhythmias.
• Diuretics (loop, thiazide): May reduce arterial responsiveness to pressors.
• Antihistamines (e.g., diphenhydramine): May potentiate the effects of epinephrine.
• Ergot alkaloids: May cause additive vasoconstriction.

• Chest pain or discomfort
• Palpitations
• Headache
• Anxiety or nervousness
• Tremor
• Dizziness
• Nausea/vomiting
• Dyspnea or wheezing (improvement or worsening)

Category C. Epinephrine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It can cause uterine vasoconstriction and decreased uterine blood flow, potentially leading to fetal hypoxia. However, in life-threatening emergencies like anaphylaxis or cardiac arrest, the benefit to the mother (and indirectly the fetus) outweighs the risk.

L3 (Moderately Safe). Epinephrine is naturally occurring and rapidly metabolized. While small amounts may be excreted in breast milk, it is unlikely to cause adverse effects in a breastfed infant due to its poor oral absorption and rapid degradation. Use is generally considered compatible with breastfeeding, especially for acute, emergency use.

Dosing is weight-based (0.01 mg/kg) for most indications. Careful attention to concentration (1:1000 vs 1:10,000) and route of administration is critical to prevent dosing errors. Pediatric patients may be more sensitive to the effects of epinephrine. Close monitoring of vital signs is essential.

Use with caution in elderly patients, who may be more susceptible to the adverse effects of epinephrine, particularly cardiovascular effects such as hypertension, arrhythmias, and myocardial ischemia. Start with lower doses and titrate carefully. Monitor closely for adverse reactions.

• Always verify the concentration of epinephrine before administration (1:1000 for IM/SC, 1:10,000 for IV/IO in cardiac arrest). Dosing errors due to concentration mix-ups are a common and dangerous problem.
• For anaphylaxis, intramuscular (IM) administration in the anterolateral thigh is preferred over subcutaneous (SC) due to faster and more reliable absorption.
• Epinephrine is light-sensitive; store in original carton until time of use. Do not use if discolored or contains precipitate.
• In cardiac arrest, administer IV/IO push, followed by a 20 mL flush and elevation of the extremity to facilitate drug delivery to central circulation.
• Patients receiving continuous IV infusions of epinephrine require arterial line monitoring for accurate blood pressure measurement.
• Extravasation of IV epinephrine can cause severe local vasoconstriction and tissue necrosis. Treat with phentolamine (alpha-blocker) infiltration if extravasation occurs.

• Norepinephrine (for shock/vasopressor support)
• Dopamine (for shock/vasopressor support)
• Phenylephrine (for vasoconstriction/hypotension)
• Isoproterenol (for bradycardia/bronchodilation - less common)
• Albuterol (for asthma/bronchodilation)
• Antihistamines (for allergic reactions, but not for anaphylaxis)
• Corticosteroids (for allergic reactions/inflammation)

If your symptoms or health problems persist or worsen, it is essential to contact your doctor for further guidance. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed to do so by a healthcare professional, avoid flushing medications down the toilet or pouring them down the drain. If you are unsure about the correct disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek medical attention. Be prepared to provide information about the medication taken, the amount, and the time it occurred.