Adrenalin Chloride (epinephrine HCl)
Nasal Decongestants Nasal Solution, Non-Oral
Last reviewed · Source: First Databank (FDB) drug data
Overview
Epinephrine, an endogenous catecholamine that is the active principle of the adrenal medulla, is a vasoconstrictor.
Epinephrine is used locally to control superficial bleeding from arterioles and capillaries in the skin and mucous membranes of the eye, nose, mouth, throat or larynx, mainly during surgery. Bleeding from larger vessels is not controllable by topical application of epinephrine. The drug is especially useful in dental surgery.
Generic name: epinephrine HCl
Drug class: Nasal Decongestants
Therapeutic class: Respiratory Therapy Agents
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Adrenalin Chloride
Indications
No indications are available for this drug.
Dosing
Dosage of epinephrine hydrochloride is expressed in terms of epinephrine.
As a vasoconstrictor to control bleeding in the mucosa or to produce nasal decongestion, a 0.1% (1:1000) solution of epinephrine is applied topically as drops or spray to mucosa as required. To control bleeding during ocular surgery or to produce conjunctival decongestion, 1 or more drops of a 0.1% (1:1000) solution of epinephrine (no longer commercially available in the US) has been applied topically to the conjunctiva 1-3 times or as necessary. To control ocular bleeding, the drug may be injected into the anterior chamber of the eye or subconjunctivally in concentrations of 0.01% (1:10,000) to 0.1% (1:1000). As a topical hemostatic, solutions containing epinephrine in concentrations of 0.002% (1:50,000) to 0.1% (1:1000) may be sprayed or applied with cotton or gauze to the skin, mucous membranes, or other tissues. In one study, 4 mL of a 0.0005% (1:200,000) solution of epinephrine was infiltrated into the buccal and labial vestibules of the maxilla and mandible in each quadrant as a hemostatic in oral surgery.
For use with local anesthetics, epinephrine may be used in concentrations of 0.0005% (1:200,000) to 0.002% (1:50,000).
Epinephrine solutions are applied topically to mucous membranes. The drug may also be injected intracamerally (into the anterior chamber of the eye) or subconjunctivally (beneath Tenon's capsule) to control hemorrhage. Epinephrine nasal and topical solutions must not be injected.
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No dosing information is available for this tab.
Drug interactions
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There are no contraindication interactions for this drug.
There are no severe interactions for this drug.
Moderate Interaction: Assess the risk to the patient and take action as needed.
Intranasal Decongestants/Zavegepant
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: Intranasal decongestants may decrease the absorption of zavegepant.(1)
CLINICAL EFFECTS: Concurrent administration of intranasal decongestants may result in decreased systemic exposure and effectiveness of zavegepant.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Avoid concurrent use of intranasal decongestants with zavegepant. If concurrent use is unavoidable, use the decongestant at least 1 hour after zavegepant.(1)
DISCUSSION: Intranasal decongestants may lower absorption of zavegepant. This effect has not been clinically evaluated.(1)
Contraindications
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- Angle-closure glaucoma
- Cardiac arrhythmia
- Congenital long QT syndrome
- Coronary artery disease
- Psychoneurotic personality disorder
- Aphakia
- Cerebral arteriosclerosis
- Diabetes mellitus
- Hypertension
- Hyperthyroidism
- Kidney disease with reduction in glomerular filtration rate (GFr)
- Parkinsonism
Adverse reactions
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Rare or Very Rare
- Cardiac arrhythmia
- Hyperhidrosis
- Insomnia
- Nervousness
- Pallor
- Tachycardia
More Frequent
- Fatigue
- Headache disorder
- Nasal passage irritation
- Paresthesia
- Pharyngitis
- Rhinorrhea
- Sneezing
Less Frequent
- Acute abdominal pain
- Acute cognitive impairment
- Angina
- Bronchial congestion
- Dizziness
- Dry nose
- Dry throat
- Epistaxis
- General weakness
- Gingival pain
- Hypertension
- Nausea
- Oral hypoesthesia
- Palpitations
- Rebound nasal congestion
- Symptoms of anxiety
- Tremor
- Vomiting
Precautions
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Although there are no adequate and controlled studies to date in humans, epinephrine has been shown to be teratogenic in rats when given at dosages 25 times the usual human dosage. Parenterally administered epinephrine in late pregnancy or labor may cause fetal anoxia. (See Cautions: Pregnancy, in Epinephrine 12:12.12.) Epinephrine should be used during pregnancy only when the potential benefits justify the possible risks to the fetus.
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No enhanced messaging available.
ICD codes
No ICD codes are available for this drug.
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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