Epinephrine

Concomitant use with halogenated hydrocarbons (e.g. halothane) or cyclopropane during general anaesthesia; concurrent administration with local anaesthetics in certain areas (e.g. ears, fingers, toes). Inhalation (when used for self-medication): Concomitant use with or within 2 weeks of discontinuing MAOI therapy. Contraindications may vary among individual products (refer to specific product guidelines).

Patient with CV disease (e.g. arrhythmias, obstructive cardiomyopathy, angina pectoris, cor pulmonale, atherosclerosis, hypertension), cerebrovascular disease, organic brain damage; Parkinson's disease, hyperthyroidism, phaeochromocytoma, narrow-angle glaucoma, high IOP, diabetes mellitus, hypokalaemia, hypercalcaemia; long-standing bronchial asthma and emphysema (who may also has degenerative heart disease); hyperreflexia, shock (other than anaphylactic shock); prostatic hypertrophy or urinary hesitancy, psychoneurotic disorder. Avoid extravasation during IV administration. Avoid use during the 2nd stage of labour or when maternal systolic/diastolic blood pressure exceeds 130/80 mmHg. Obese patient. Renal impairment. Neonates, children, and elderly. Pregnancy and lactation. Monitoring Parameters Monitor heart rate, blood pressure (invasive blood pressure while receiving continuous infusion), cardiac status (constantly during continuous infusion). Correct blood volume optimally before initiating treatment. Monitor infusion site for blanching or extravasation. Assess for cardiac arrhythmias, hyperlactataemia, and hyperglycaemia. For inhalation use: Monitor vital signs, FEV₁, peak flow, and other pulmonary function tests; CNS stimulation, asthma symptoms. Refer to local policies and guidelines for further information.

Significant: New-onset or exacerbation of angina pectoris, cardiac arrhythmias, myocardial ischaemia, pulmonary oedema, oliguria; transient blood glucose elevations (particularly in diabetic patients); metabolic acidosis (prolonged use); psychomotor agitation or temporary worsening of symptoms (e.g. rigidity, tremor) in patients with Parkinson's disease; peripheral ischaemia (accidental inj into fingers, hands, or feet). Rarely, serious skin and soft tissue infections at the inj site (e.g. necrotising fasciitis, gas gangrene). Cardiac disorders: Tachycardia, palpitations. Rarely, stress cardiomyopathy. Gastrointestinal disorders: Nausea, vomiting. General disorders and administration site conditions: Asthenia. Nervous system disorders: Headache, dizziness, tremor. Psychiatric disorders: Anxiety. Skin and subcutaneous tissue disorders: Hyperhidrosis, pallor. Vascular disorders: Hypertension.

Increased risk of severe, prolonged hypertension with MAOIs. May cause additive effect and increase the risk of toxicity with other sympathomimetic agents. May potentiate α-adrenergic action with oxytocin. Vasoconstrictive and hypertensive effects may be antagonised by rapidly acting vasodilators (e.g. nitrates) or α-adrenergic blockers (e.g. phentolamine). May cause severe hypertension and reflex bradycardia with non-selective β-blocking agents (e.g. propranolol). β-blocking agents may antagonise the cardiac and bronchodilating effects of epinephrine. Ergot alkaloids may reverse the pressor effect of epinephrine. TCAs (e.g. imipramine) may potentiate the effect of epinephrine, which increases the risk of hypertension and cardiac arrhythmias. May potentiate arrhythmogenic effect with certain antihistamines (e.g. diphenhydramine), cardiac glycosides, quinidine, and thyroid hormones. May increase the risk of hypokalaemia with K-depleting diuretics, corticosteroids, aminophylline, and theophylline. May inhibit insulin secretion which may result in loss of blood glucose control in diabetic patients; dosage adjustment of insulin or oral hypoglycaemic agents may be needed. May reverse the antihypertensive effects of adrenergic neuron blockers (e.g. guanethidine).

Antiasthmatic & COPD Preparations / Cardiac Drugs / Vasoconstrictors

B02BC09 - epinephrine ; Belongs to the class of local hemostatics. Used in the treatment of hemorrhage.
A01AD01 - epinephrine ; Belongs to the class of other agents for local oral treatment.
R03AA01 - epinephrine ; Belongs to the class of adrenergic inhalants, alpha- and beta-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
C01CA24 - epinephrine ; Belongs to the class of adrenergic and dopaminergic cardiac stimulants excluding glycosides. Used in the treatment of heart failure.
S01EA01 - epinephrine ; Belongs to the class of sympathomimetics used in the treatment of glaucoma.
R01AA14 - epinephrine ; Belongs to the class of topical sympathomimetic agents used as nasal decongestants.