How it is administered

Epinephrine is available as an injection and is commonly administered in several ways:

• Intramuscular (IM) or Subcutaneous (SC) Injection: For emergency treatment of severe allergic reactions (anaphylaxis), epinephrine is injected into the outer thigh, often using an auto-injector device.
• Intravenous (IV) Infusion: For patients with severe low blood pressure (hypotension) associated with septic shock, epinephrine is given as a diluted solution through a vein, usually in a hospital setting.
• Presentations: It is supplied in single-dose auto-injectors (0.3 mg or 0.15 mg), vials, and pre-mixed infusion bags for IV use.

Always follow your healthcare provider’s instructions for administration.

How it works

Epinephrine works by stimulating both alpha and beta-adrenergic receptors in your body. This results in several important effects:

• Increases Blood Pressure: Epinephrine causes the heart to beat stronger and faster (positive inotropic and chronotropic effects) and narrows blood vessels (vasoconstriction), which raises blood pressure. This is especially important in treating shock, where blood pressure is dangerously low.

• Relieves Allergic Reactions: During anaphylaxis, epinephrine reduces swelling, relaxes the muscles in the airways to make breathing easier, and reverses the dangerous drop in blood pressure. It also helps relieve symptoms like hives and swelling by reducing the release of allergy mediators.

• Short Acting: Epinephrine acts quickly but its effects do not last long, so medical attention is still needed after its use.

These actions make epinephrine a life-saving medication in emergencies such as severe allergic reactions and shock.

Who Should take it

Epinephrine is indicated for:

• Emergency treatment of severe allergic reactions (anaphylaxis), including those caused by foods, insect stings, medications, or other allergens. It is also used for idiopathic (unknown cause) or exercise-induced anaphylaxis.
• Raising blood pressure in adults with hypotension associated with septic shock, especially when other treatments have not worked.

If you have a history of severe allergic reactions, your doctor may prescribe an epinephrine auto-injector for you to carry at all times. In the hospital, it may be used to stabilize blood pressure in critical care situations.

Who should not take it

There are no absolute contraindications to using epinephrine in life-threatening situations like anaphylaxis or severe shock—its benefits far outweigh the risks in these emergencies.

However, epinephrine should be used with caution in people with:

• Heart disease (such as arrhythmias, coronary artery disease, or high blood pressure)
• Certain other conditions like hyperthyroidism, diabetes, Parkinson’s disease, or in elderly individuals

Despite these concerns, if you are experiencing a life-threatening allergic reaction or shock, epinephrine should be used as directed. Always inform your healthcare provider about your medical history.

Commonly used with

Epinephrine is often used alongside other emergency treatments, especially in the hospital. For anaphylaxis, it may be followed by antihistamines, corticosteroids, or inhaled bronchodilators. In shock, it may be used with fluids, antibiotics, and other medications to support blood pressure.

Commonly tested with

Epinephrine is frequently studied in combination with other vasopressors (like norepinephrine or dopamine) in shock, and with other allergy medications (antihistamines, corticosteroids) in anaphylaxis. In clinical settings, it is often part of a broader emergency protocol for allergic reactions or shock.