Epinephrine 1mg/ml Inj, 30ml Vial

Epinephrine is a sympathomimetic agent acting on alpha- and beta-adrenergic receptors. Its alpha-1 adrenergic effects (vasoconstriction) increase peripheral vascular resistance and blood pressure, reducing mucosal edema. Its beta-1 adrenergic effects (positive inotropic and chronotropic) increase heart rate and myocardial contractility. Its beta-2 adrenergic effects (bronchodilation) relax bronchial smooth muscle and reduce histamine release from mast cells.

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, such as:
+ 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
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of low potassium levels, including:
+ Muscle pain or weakness
+ Muscle cramps
+ An irregular heartbeat
Signs of high blood pressure, such as:
+ Severe headache or dizziness
+ Passing out
+ Changes in eyesight
Chest pain or pressure
Rapid heartbeat
Shortness of breath
Urination problems, such as difficulty starting to urinate or changes in urine output
Abnormal sensations, such as burning, numbness, or tingling
Weakness on one side of the body
Trouble speaking or thinking
Changes in balance
Drooping on one side of the face
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 any allergic reactions, watch for signs of infection at the injection site, such as:
Redness that doesn't go away
Warmth
Swelling
Tenderness

If you receive this medication through a vein, monitor the injection site for:
Redness
Burning
Pain
Swelling
Blisters
Skin sores
Leaking of fluid

Other Possible Side Effects

Most people taking this medication do not experience severe side effects. However, some may occur. If you experience any of the following side effects, contact your doctor if they bother you or do not go away:
Feeling anxious, nervous, excitable, shaky, or restless
Upset stomach or vomiting
Excessive sweating
Pale skin
Headache
Dizziness
Fatigue
Weakness
Goosebumps

This is not an exhaustive list of possible side effects. If you have questions or concerns, 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, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor assess potential interactions between this medication and other substances you are taking.
* Any health problems you have, as they may affect the safety and efficacy of this medication.

Remember, this is not an exhaustive list of potential interactions. To ensure your safety, it is crucial to discuss all your medications and health problems with your doctor and pharmacist. Never start, stop, or change the dose of any medication without first consulting your doctor to confirm that it is safe to do so.

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

When administering this drug, avoid injecting it into the fingers, hands, or feet, as this may cause reduced blood flow to these areas. If accidental injection occurs, seek immediate medical attention.

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

Patients with high blood sugar (diabetes) should closely monitor their blood sugar levels while taking this drug.

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

Before taking this medication, inform your doctor if you are pregnant, planning to become pregnant, or are breast-feeding. Your doctor will discuss the potential benefits and risks of this medication to both you and your baby.

• Non-selective beta-blockers (e.g., propranolol, nadolol): May result in severe hypertension and reflex bradycardia due to unopposed alpha-adrenergic effects.
• Cocaine: Potentiates cardiac effects, increasing risk of arrhythmias and hypertension.
• General anesthetics (e.g., halothane, cyclopropane): May sensitize the myocardium to epinephrine, increasing risk of ventricular arrhythmias.

• Tricyclic antidepressants (TCAs) and MAO inhibitors (MAOIs): May potentiate the pressor effects of epinephrine, leading to hypertensive crisis.
• Alpha-adrenergic blockers (e.g., phentolamine): May antagonize the pressor effects of epinephrine.
• Diuretics (e.g., loop, thiazide): May reduce the pressor response to vasopressors.
• Cardiac glycosides (e.g., digoxin): Increased risk of arrhythmias.
• Antidiabetic agents: Epinephrine can increase blood glucose levels, requiring adjustment of antidiabetic therapy.

• Chest pain or discomfort (angina)
• Palpitations
• Headache
• Anxiety or nervousness
• Tremor
• Dizziness
• Nausea/vomiting
• Dyspnea or worsening respiratory distress
• Skin pallor or flushing

Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Epinephrine can cause fetal anoxia due to uterine vasoconstriction and can inhibit uterine contractions. However, in life-threatening situations (e.g., anaphylaxis, cardiac arrest), the benefits of maternal treatment outweigh potential fetal risks.

L3 (Moderately Safe). Epinephrine is rapidly metabolized and has a very short half-life, making infant exposure through breast milk unlikely to be significant. It is considered compatible with breastfeeding when used for acute, life-threatening conditions.

Dosing is weight-based (0.01 mg/kg) for most indications. Careful attention to concentration and route of administration is critical to avoid dosing errors. For cardiac arrest, the 1mg/ml solution must be diluted to 0.1mg/ml (1:10,000) for IV/IO administration. For anaphylaxis, the 1mg/ml solution is used IM/SC. Neonates and infants are particularly sensitive to adverse effects.

Use with caution in elderly patients due to increased risk of adverse cardiovascular effects (e.g., hypertension, arrhythmias, myocardial ischemia) and pre-existing cardiovascular disease. Start with lower doses and titrate carefully. Monitor closely for adverse effects.

• Epinephrine is the first-line treatment for anaphylaxis. Administer IM into the anterolateral thigh.
• For cardiac arrest, the 1mg/ml (1:1000) solution must be diluted to 0.1mg/ml (1:10,000) for IV/IO administration.
• Do not inject IV for anaphylaxis unless in a controlled ICU setting with continuous cardiac monitoring due to risk of severe hypertension, arrhythmias, and myocardial ischemia.
• Protect from light and store at room temperature. Discard if discolored or contains precipitate.
• Patients with underlying cardiovascular disease, hyperthyroidism, or diabetes are at higher risk for adverse effects.
• Accidental intravascular injection of epinephrine can cause severe hypertension and cerebral hemorrhage.

• Norepinephrine (for shock, vasopressor)
• Dopamine (for shock, vasopressor)
• Phenylephrine (for hypotension, vasopressor)
• Albuterol (for bronchospasm, beta-2 agonist)
• Antihistamines (for allergic reactions, but not for anaphylaxis)
• Corticosteroids (for allergic reactions, but not for acute anaphylaxis)

If your symptoms or health problems do not improve or worsen over time, it is essential to contact your doctor for further evaluation and guidance. To ensure safe use, never share your prescription medications with others, and do not take medications prescribed to someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Properly dispose of unused or expired medications by checking with your pharmacist for guidance on the best disposal method. Unless instructed to do so, avoid flushing medications down the toilet or pouring them down the drain, as this can harm the environment. Many communities offer drug take-back programs, which can be a safe and convenient way to dispose of unwanted medications. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, consult with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide information about the medication taken, the amount, and the time it was taken, as this will help healthcare providers deliver appropriate care.