Drug Database
EP

epinephrine (epinephrine, Dey / EpiPen / epinephrine, Mylan)

✓ Approved

Mylan · Small Molecule · Small Molecule

What is epinephrine?

epinephrine is a small molecule developed by Mylan. It is approved for therapeutic indications via injectable (others).

Drug Profile

Brand Namesepinephrine, Dey, EpiPen, epinephrine, Mylan
CompanyMylan
Drug ClassSmall Molecule
RouteInjectable (Others)
StatusApproved
Sources: ClinicalTrials.gov, Mylan

Therapeutic Indications

epinephrine is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Immune system disordersAnaphylactic reaction✓ Approved

Related Research Articles

PubMedBMJ case reports2026-09-18

Critical airway obstruction associated with extensive subglottic inflammatory slough and oedema following severe acute respiratory syndrome SARS-CoV-2 infection in a child.

Ota Yoichiro Y, Ito Yusuke Y, Omura Kazuhiro K

SARS-CoV-2 infection in children is typically mild, although COVID-19-associated croup can be severe. We report a patient in middle childhood with impending critical airway obstruction due to severe subglottic oedema and extensive inflammatory slough/crusting following SARS-CoV-2 infection. Subsequent airway assessment in the operating theatre revealed critical subglottic narrowing. During transport, nebulised epinephrine was initiated; however, the patient developed hypoxaemia (SpO2 80%) with loss of consciousness. On arrival, video-laryngoscopic removal of obstructive slough using Magill forceps and Yankauer suction restored spontaneous ventilation with forceful expectoration of residual debris. Because of persistent severe oedema, endotracheal intubation required a markedly undersized tube for the patient's predicted size (internal diameter 4.5 mm). Following unplanned self-extubation on day 1, residual subglottic oedema and slough were managed with nebulised epinephrine and dexamethasone without re-intubation. The patient was discharged on day 10 without complications. This case highlights the importance of definitive airway management in a controlled setting.

PMID 42760026
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PubMedFrontiers in oncology2026-09-18

A case report of a composite pheochromocytoma that occurred 13 years after adrenalectomy for pheochromocytoma.

Min Min M, Zhang Jie J, Liu Gui-Xi GX, He Jing J

To analyze the clinicopathological features, surgical management, and long-term prognosis of a composite pheochromocytoma (CP; pheochromocytoma combined with ganglioneuroma) arising 13 years after resection of a primary adrenal pheochromocytoma, with the aim of improving the clinical diagnosis and management of this rare neoplasm. A 61-year-old Han male had undergone left adrenal pheochromocytoma resection 13 years prior to the current presentation. An asymptomatic left adrenal nodule was incidentally detected during a routine physical examination, and the patient was subsequently admitted to the Department of Urology at The Third Hospital of Mianyang. He denied any history of other chronic systemic illnesses. Admission biochemistry revealed only a mild elevation of epinephrine, with the concentration remaining below twice the upper limit of normal. Abdominopelvic contrast-enhanced computed tomography (CT) identified a well-circumscribed hypodense nodule measuring 2.6 × 2.1 cm beneath the left adrenal gland, demonstrating marked nodular and peripheral ring enhancement; a separate hypodense nodule with a maximum diameter of 1.8 cm was also noted in the right adrenal fossa. Based on his disease history and imaging findings, recurrence of left adrenal pheochromocytoma was strongly suspected, and a synchronous right adrenal pheochromocytoma could not be excluded. The patient consented only to partial left adrenalectomy. Intraoperative exploration revealed adhesions among the descending colon, peritoneum, and spleen, as well as multiple solid masses (maximum size 2.0 × 2.0 cm) in the left adrenal region that were densely adherent to the pancreatic parenchyma. The resected specimens were submitted for pathological evaluation. Histopathological examination confirmed a composite pheochromocytoma with cystic change, multifocal coagulative necrosis, and adipose tissue invasion. The patient experienced an uneventful postoperative recovery. During the subsequent 11-month follow-up period, no recurrence or distant metastasis was detected, and the patient remained clinically stable. It remains challenging to definitively establish whether the left adrenal composite pheochromocytoma (CP) detected in this patient represents true tumor recurrence 13 years after the initial surgery. Archival pathological slides from the primary operation were unavailable for comparative histologic and clonal analysis. Moreover, the original lesion was diagnosed as a pure pheochromocytoma, whereas the current mass harbors an additional mature ganglioneuromatous component displaying distinct histological features. Given the lack of evaluable surgical margins from the initial partial adrenalectomy, the possibility of minimal residual disease cannot be excluded. Accordingly, two possibilities are proposed: late ipsilateral recurrence of the original chromaffin tumor, or a metachronous de novo primary CP arising independently in the left adrenal gland. In contrast to most previously documented CP cases, this patient exhibited isolated mild epinephrine elevation without catecholamine-related clinical manifestations, underscoring that regular physical screening and postoperative histopathology constitute the main diagnostic pillars. Surgical resection remains the first-line therapy. Regardless of its origin, long-term regular surveillance is mandatory, given the inherent metastatic potential of pheochromocytomas and paragangliomas (PPGLs).

PMID 42755565
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PubMedCureus2026-09-18

Refractory Bradycardia in the Late Phase of Necrotizing Pancreatitis: A Case Report.

Kramchi Youssra Y, Jeddab Achraf A, Errachki Mouaad M, Jidal Marouane M et al.

ECG abnormalities are common in acute pancreatitis, yet clinically significant bradyarrhythmias are rarely reported and have been described mainly in the early phase of the disease. We report the case of a 76-year-old hypertensive male who developed severe acute post-endoscopic retrograde cholangiopancreatography pancreatitis, complicated by infected pancreatic necrosis requiring readmission to the intensive care unit on day 20. He was managed with CT-guided drainage and culture-directed antibiotics. In the fourth week of illness, he developed recurrent sinus bradycardia, at times triggered by vagal stimuli (nasogastric tube placement and posture change) and at times occurring spontaneously. On days 25 and 28, he developed severe bradycardia refractory to IV atropine, progressing to cardiac arrest on both occasions; each was managed with brief CPR and a 1 mg IV bolus of epinephrine, with return of spontaneous circulation. On day 30, a further arrest occurred and could not be reversed despite prolonged CPR. Throughout these episodes, serial ECGs showed sinus bradycardia without conduction block, cardiac enzymes and echocardiographic parameters remained unremarkable, electrolytes were within normal range, and inflammatory biomarkers were declining; these findings did not support an alternative reversible cause. We discuss the potential pathophysiological mechanisms underlying this presentation and suggest that life-threatening bradyarrhythmias may also arise in the late phase of necrotizing pancreatitis, raising the case for a low threshold for proactive, aggressive management of bradyarrhythmia in this setting.

PMID 42756784
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PubMedJournal of neurosurgery. Spine2026-09-18

Comparison of liposomal bupivacaine and modified cocktail analgesia for postoperative pain control after transforaminal lumbar interbody fusion: a prospective, double-blind, randomized controlled trial.

Li Junhu J, Yao Mei M, Chen Jin J, Yang Zhiqiang Z et al.

Postoperative incisional pain remains a major clinical challenge after transforaminal lumbar interbody fusion (TLIF). Liposomal bupivacaine (LB) and modified cocktail analgesia have shown analgesic efficacy in other surgical settings, but their comparative value in TLIF remains unclear. This study compared the analgesic effectiveness of LB versus a modified cocktail regimen administered via an erector spinae plane block (ESPB) in patients undergoing TLIF. In this prospective, double-blind, randomized controlled trial, 181 patients were screened and 118 eligible patients were randomized equally to the LB group or the modified cocktail group (n = 59 each). In both groups, the study drug was administered via ESPB at the surgical level. The LB group received 266 mg LB diluted to 80 ml. The modified cocktail group received ropivacaine, epinephrine, dexamethasone, magnesium sulfate, and sodium bicarbonate. All other perioperative management was identical. The primary outcome was total postoperative rescue morphine consumption. Secondary outcomes included time to first rescue analgesia; 24-hour morphine consumption; number of rescue analgesia events; patient-controlled analgesia (PCA) activations and consumption; visual analog scale (VAS) pain scores at rest and during activity at 3, 6, 12, 24, 36, 48, and 72 hours; time to first ambulation; ambulation distance; length of hospital stay; and postoperative complications. The LB group required significantly less total postoperative rescue morphine than the modified cocktail group (mean 16.2 [SD 11.6] vs 22.6 [SD 12.0] mg, p = 0.020). No significant differences were noted in the median time to first rescue analgesia (20.6 [IQR 8.3-36.6] vs 10.0 [IQR 3.2-27.9] hours, p = 0.074), mean morphine consumption within 24 hours (7.1 [SD 2.5] vs 7.2 [SD 2.5] mg, p = 0.894), or mean number of rescue analgesia events (2.4 [SD 1.4] vs 3.3 [SD 2.1] events, p = 0.058). The LB group had markedly fewer PCA activations (mean 7.3 [SD 6.4] vs 17.6 [SD 10.1] activations, p < 0.001) and lower total PCA drug use (mean 33.4 [SD 23.1] vs 62.8 [SD 27.8] ml, p < 0.001). Significant intergroup differences in VAS pain scores appeared only at 24 and 36 hours postoperatively. Both LB and the modified cocktail regimen administered via ESPB effectively reduced early incisional pain after TLIF. The modified cocktail provided satisfactory analgesia within 24 hours at substantially lower cost, whereas LB offered more prolonged analgesia up to 36 hours, with reduced opioid consumption and PCA demand. Chinese Clinical Trial Registry no.: ChiCTR2400089275 (https://www.chictr.org.cn/index.html).

PMID 42759062
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PubMedPLOS digital health2026-09-17

A medically grounded LLM agent-based tool to detect patient safety events in medical records.

Trujillo Diego D, Wang Dulin D, Bahr Nathan N, Yi-Jin Hsieh Tina T et al.

Large language models (LLMs) have shown incredible promise in medicine. While LLMs may be particularly useful in areas requiring extensive review of clinical records, their use remains limited due to their tendency to hallucinate and fabricate information. Hallucination issues, as well as their consequences, are exacerbated in low-probability, high-stakes scenarios such as rare adverse safety events or medical errors. We present SAFE-AI (Structured and Automated Framework for Explainable AI), a novel method for clinical decision making that combines the strengths of clinical expert knowledge with LLMs in an ontology-driven model that minimizes hallucinations using strict rules. We test this method to identify medication errors in medical charts. We collected a sample of 18,402 lines of clinical information from 300 EMS clinical charts that were independently dually reviewed by two expert physicians for epinephrine adverse safety events (ASEs), with 96% inter-rater agreement. We tested SAFE-AI against these labels, achieving similar performance to human experts in detecting epinephrine overdoses with 97.9% accuracy, and 91.6% accuracy in identifying delays in epinephrine administration, greatly outperforming baseline LLMs models. Notably, some disagreements between clinicians and the model were found to be justifiable differences in judgment rather than errors. SAFE-AI presents a novel approach for clinical AI applications that addresses two key limitations of current machine learning methods: 1) over-reliance on probabilistic pattern recognition instead of established medical knowledge, and 2) perpetuation of biases present in training data. This framework is easily adaptable to a range of clinical applications, paving the way for provable and trustworthy AI in medicine.

PMID 42752617
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PubMedRevue medicale de Liege2026-09-17

[Anaphylaxis to MMR vaccine gelatin : practical recommendations].

Iordachescu Mihai M, El Abd Kamal K

This article reports two pediatric cases of anaphylaxis to the M-M-RVaxPro® vaccine, attributable to porcine gelatin used as a stabilizer (14.5 mg/dose). Both patients developed severe reactions after the booster dose, with positive skin and blood tests for gelatin. The first case had hereditary alpha-tryptasemia as an aggravating factor. Investigations ruled out the responsibility of neomycin, latex, and chlorhexidine. Key recommendations include avoidance of gelatin-containing vaccines and medications, substitution with gelatin-free alternatives (Priorix®), evaluation of food tolerance through an oral challenge test, and provision of an emergency kit with epinephrine. Hospital monitoring is recommended for future vaccinations in patients with mast cell disorders. The study highlights gelatin as the primary culprit in vaccine anaphylaxis, emphasizing the importance of systematic testing for vaccine components and proper management of sensitized patients.

PMID 42751843
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