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What is the most important information I should know about epinephrine?

Before using this medication, tell your doctor if you have heart disease or high blood pressure, a heart rhythm disorder, coronary artery disease, Parkinson’s disease, diabetes, or a thyroid disorder.

Before using epinephrine, tell your doctor about all other medications you use, especially digoxin (digitalis, Lanoxin), heart or blood pressure medicine, heart rhythm medication, an antidepressant, a diuretic (water pill), thyroid medication, migraine headache medicine, cold or sleep medicine that contains an antihistamine, or an MAO inhibitor such as Marplan, Nardil, Azilect, Eldepryl, Emsam, or Parnate.

Do not inject epinephrine into a vein or into the muscles of your buttocks, or it may not work as well. Inject it only into the fleshy outer portion of the thigh.

Accidentally injecting epinephrine into your hands or feet may result in a loss of blood flow to those areas, and resulting numbness. If this occurs, seek emergency medical attention.

Seek emergency medical attention even after you use epinephrine to treat a severe allergic reaction. The effects of epinephrine injection may wear off after 10 or 20 minutes. You will need to receive further treatment and observation.

Before using epinephrine a second time, tell your doctor if your first injection caused a serious side effect such as increased breathing difficulty, or dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Store the auto-injector device in the original tube it came in. Keep this tube at room temperature away from direct sunlight, heat, and moisture. Do not refrigerate this medication, or store it in a car.

Warning

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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What is epinephrine?

Epinephrine is a chemical that narrows blood vessels and opens airways in the lungs. These effects can reverse severe low blood pressure, wheezing, severe skin itching, hives, and other symptoms of an allergic reaction.

Epinephrine injection is used to treat severe allergic reactions (anaphylaxis) to insect stings or bites, foods, drugs, and other allergens. Epinephrine is also used to treat exercise-induced anaphylaxis.

Epinephrine auto-injectors such as EpiPen and EpiPen Jr. may be kept on hand for self-injection by a person with a history of an severe allergic reaction.

Epinephrine injection may also be used for other purposes not listed in this medication guide.

Precautions

If you have certain conditions, you may not be able to use epinephrine, or you may need a dose adjustment or special tests to safely use the medication. Before using epinephrine, tell your doctor if you have:

  • heart disease or high blood pressure;
  • a heart rhythm disorder;
  • coronary artery disease;
  • Parkinson's disease;
  • diabetes; or
  • a thyroid disorder.

FDA pregnancy category C. It is not known whether epinephrine is harmful to an unborn baby. If possible before using this medication, tell your doctor if you are pregnant or plan to become pregnant.

Before an emergency occurs, talk to your doctor about using epinephrine injection if you are breast-feeding a baby.

Do not inject epinephrine into a vein or into the muscles of your buttocks, or it may not work as well. Inject it only into the fleshy outer portion of the thigh.

Accidentally injecting epinephrine into your hands or feet may result in a loss of blood flow to those areas, and resulting numbness. If this occurs, seek emergency medical attention.

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Instructions

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include fast or pounding heartbeats, sudden and severe headache, sudden numbness or weakness, feeling like you might pass out, or sudden problems with vision, speech, or balance.

Since epinephrine is normally used only as needed in an emergency, you are not likely to be on a dosing schedule. Do not use repeat doses of epinephrine injection without a doctor’s advice.

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Side Effects

Before using epinephrine a second time, tell your doctor if your first injection caused a serious side effect such as increased breathing difficulty, or dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious side effects may include:

  • fast, pounding, or uneven heatbeats;
  • sweating;
  • nausea and vomiting;
  • pale skin;
  • dizziness;
  • weakness or tremors;
  • headache; or
  • feeling nervous or anxious.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may report side effects to FDA at 1-800-FDA-1088.

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Interactions

The following drugs can interact with epinephrine injection. Tell your doctor if you are using any of these:

  • digoxin (digitalis, Lanoxin, Lanoxicaps);
  • cold or sleep medication that contains chlorpheniramine (Coricidin, Robitussin Cough and Cold, Triaminic Allergy, and others) or diphenhydramine (Benadryl, Sominex, Nytol, Compoz, and others);
  • a diuretic (water pill);
  • levothyroxine (Synthroid);
  • an antidepressant such as amitriptyline (Elavil, Etrafon), doxepin (Sinequan), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), and others;
  • a beta-blocker such as propranolol (Inderal, InnoPran), and others;
  • ergot medicine such as ergotamine (Ergomar), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), or methylergonovine (Methergine);
  • heart rhythm medication such as quinidine (Cardioquin, Quinaglute, Quinidex); or
  • an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).

This list is not complete and there may be other drugs that can interact with epinephrine injection. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

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Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04