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

PubMedCanadian journal of ophthalmology. Journal canadien d'ophtalmologie2026-07-25

A case of bupivacaine-induced cardiotoxicity during a blepharoplasty.

Becker Bruce B BB, Goodyear Kendall K

Bupivacaine is the most cardiotoxic local anesthetic. We present a case of a healthy 63-year-old female with no history of arrhythmias, ischemia, or other cardiac disease who had a cardiac arrest caused by bupivacaine during a blepharoplasty. A 63-year-old healthy female with no history of arrhythmias, ischemia or other cardiac disease presented for an upper and lower blepharoplasty. Intraoperatively a total of 12 ccs of 1:1 lidocaine 2% with 1:100,000 epinephrine and bupivacaine 0.50% with 1:100,000 epinephrine was given subcutaneously and subconjunctivally in the lower eyelids. The patient developed ventricular tachycardia progressing to asystole 5 minutes after the injections. Cardiopulmonary resuscitation led to a return of circulation. Extensive investigations, including consultations with cardiologists and electrophysiologists, ruled out underlying cardiac pathology, and the cardiac arrest was determined to result from bupivacaine cardiotoxicity. This case highlights the potential for cardiac complications from the local administration of bupivacaine. It emphasizes the need for cardiac monitoring and the resources for cardiopulmonary resuscitation when using bupivacaine in periorbital anesthesia.

PMID 42498256
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PubMedJournal of thrombosis and haemostasis : JTH2026-07-25

Rab31 promotes platelet activation and arterial thrombosis via ERK-PLCβ3 signaling and regulation of CD151.

Wang Yixian Y, Luo Jiajia J, Liu Jingjing J, Yang Qingyuan Q et al.

Rab GTPases regulate vesicular trafficking and membrane dynamics, processes essential for platelet activation. Although several Rab family members are expressed in platelets, the role of Rab31 remains undefined. To determine the role of Rab31 in platelet activation, thrombosis, and hemostasis and to explore the underlying mechanisms. Rab31 expression was examined in human and murine platelets. Platelet function was evaluated in Rab31-/- and wild type mice using aggregation, ATP release, spreading, and clot retraction assays. In vivo thrombosis and hemostasis were assessed by FeCl3-induced mesenteric arterial injury, collagen/epinephrine-induced pulmonary embolism, tail-snip bleeding, and platelet depletion and repletion experiments. Quantitative proteomic and phosphoproteomic analyses were performed to identify Rab31-dependent signaling pathways in platelets. Rab31 was expressed in human and murine platelets at both mRNA and protein levels. Rab31 deficiency significantly reduced platelet aggregation, ATP secretion, spreading, and clot retraction. In vivo, Rab31-/- mice showed delayed arterial thrombus formation and reduced pulmonary embolism, whereas tail bleeding time and blood loss were unchanged. Platelet depletion and repletion experiments confirmed the platelet intrinsic role of Rab31 in thrombosis. Phosphoproteomic analysis revealed decreased ERK2 and PLCβ3 phosphorylation in Rab31-deficient platelets, and quantitative proteomics identified reduced CD151 expression. These findings were validated by immunoblotting. Rab31 promotes platelet activation and arterial thrombosis without affecting physiological hemostasis, likely through regulation of ERK-PLCβ3 signaling and CD151 expression.

PMID 42498138
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PubMedEmergency medicine journal : EMJ2026-07-24

Association between the timing of prehospital epinephrine administration and patient outcomes after out-of-hospital cardiac arrest in Korea: a nationwide observational study.

Lee Seung Hyo SH, Hong Won Pyo WP, Park Jeong Ho JH, Kim Minjung M et al.

The optimal timing of epinephrine during out-of-hospital cardiac arrest (OHCA) remains uncertain, particularly for neurological recovery. We examined the association between time-to-epinephrine and clinical outcomes in adult OHCA in Korea. We conducted a nationwide retrospective cohort of emergency medical service (EMS)-treated, non-traumatic adult OHCA (2019-2021). Patients were classified as early (≤20 min) or delayed (>20 min) based on arrest-to-first epinephrine. The primary outcome was favourable neurological status at discharge (Cerebral Performance Category (CPC) 1-2); secondary outcomes were return of spontaneous circulation (ROSC) and survival to discharge. We applied 1:1 propensity-score matching and multivariable logistic regression, including continuous (per 1-minute and 5-minute delays) and 5-minute bin analyses of time-to-epinephrine, with effect modification assessed by initial rhythm. Among 10 726 patients, 3589 (33.5%) received epinephrine within 20 min. In the matched cohort (n = 5,734), delayed administration was associated with lower survival (4.46% vs 7.74%; aOR 0.56, 95% CI 0.44-0.71) and lower likelihood of favourable neurological outcome (2.13% vs 3.77%; aOR 0.56, 95% CI 0.40-0.79), compared with early administration. In continuous models, each 1-minute delay was associated with lower odds of good CPC (aOR 0.964, 95% CI 0.942 to 0.987); a 5-minute delay corresponded to aOR 0.833 (95% CI 0.741 to 0.937) and bin-wise estimates showed a marked drop beyond 30 min (aOR 0.048, 95% CI 0.006 to 0.393). Early epinephrine administration within 20 min of cardiac arrest onset was associated with higher rates of ROSC, survival to discharge and favourable neurological recovery in this EMS setting. These findings support the importance of timely advanced life support delivery, including early epinephrine, although cautious interpretation is warranted.

PMID 42493234
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PubMedPediatric research2026-07-24

Effect of sustained inflation on pharmacokinetics and pharmacodynamics of endotracheal and supraglottic airway epinephrine in a neonatal piglet model.

Zhou Ming M, Liu Jiang-Qin JQ, Ramsie Marwa M, Cheung Po-Yin PY et al.

During neonatal resuscitation, the preferred route is intravenous (IV) or intraosseous (IO) administration, while endotracheal (ETT) delivery is a temporary solution. Supraglottic airway (SGA) devices are an alternative route to ETT administration. We compared the pharmacokinetics (PK) and pharmacodynamics (PD) of epinephrine administered via ETT and SGA, as well as the impact of a sustained inflation to enhance drug absorption by pushing the drug into the lung. Thirty newborn anesthetized normoxic piglets (1-4 days old, 1.7-2.4 kg) were randomized to receive 0.1 mg/kg epinephrine via ETT, SGA (top or bottom placement), or combined with SI. Hemodynamic parameters (heart rate [HR], mean arterial pressure [MAP], and carotid blood flow [CBF]) and plasma epinephrine concentrations were measured at baseline and 1-10 min post-administration. ETT administration resulted in significantly higher HR, CBF, MAP, and plasma epinephrine concentrations compared to SGA routes (all p < 0.05), with peak concentrations achieved within 2 min versus the delayed, lower peaks in the SGA groups. SI did not enhance PK/PD outcomes in either the ETT or SGA groups. ETT administration resulted in significantly higher hemodynamic parameters compared to SGA, An SI did not enhance pharmacokinetic or pharmacodynamic outcomes in either the ETT or SGA groups. Endotracheal (ETT) epinephrine administration produced significantly higher plasma concentrations and stronger hemodynamic responses than supraglottic airway (SGA) delivery in a newborn piglet model. This study is the first to directly compare pharmacokinetics and pharmacodynamics of epinephrine delivered via ETT versus multiple SGA positions, with and without sustained inflation (SI). SGA administration resulted in delayed and lower epinephrine absorption, indicating limited effectiveness for rapid drug delivery during neonatal resuscitation. Sustained inflation did not enhance drug absorption or hemodynamic response for either ETT or SGA routes, challenging assumptions that SI might improve pulmonary drug uptake.

PMID 42493553
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PubMedBritish journal of anaesthesia2026-07-24

Economic impact of switching to licensed ready-to-administer injectable anaesthetic and critical care medicines in the National Health Service: a model-based evaluation of prefilled syringes.

Al-Rawi Suzanne S, Mehta Jaidev J, Taylor Karl K, Glover David D et al.

Licensed, ready-to-administer injectable medicines can reduce medication errors, minimise waste, and streamline perioperative workflows, but higher acquisition costs have limited uptake in England. This study evaluated the economic impact of switching selected anaesthetic and critical care medicines from conventional ampoules and vials to licensed prefilled syringes within NHS practice. An economic model compared current mixed-use practice with a hypothetical switch to 100% licensed ready-to-administer products for eight medicines: epinephrine 1 mg in 10 ml, ephedrine 30 mg, atropine 3 mg, rocuronium 100 mg in 10 ml, lidocaine (1% and 2%), and midazolam (5 mg in 5 ml and 50 mg in 50 ml). Modelled cost components included medicine acquisition, wastage, nursing preparation time, consumables and preventable adverse drug events. Preparation time reductions were interpreted as capacity release rather than workflow substitution. Deterministic sensitivity analyses explored variation in key assumptions and procurement thresholds. Under the modelling assumptions, epinephrine, ephedrine, atropine and lidocaine 2% were associated with reduced overall system costs of more than £5.3 million annually, largely driven by reduced wastage, preparation workload and modelled adverse drug events. Rocuronium and midazolam were associated with increased costs because of higher acquisition prices despite operational advantages. Sensitivity analyses did not alter the direction of findings. Substantial price reductions would be required for certain medicines to achieve cost neutrality. Licensed ready-to-administer injectable medicines can provide safety and workflow advantages and be associated with economic benefit. Acquisition cost remains a barrier, but broader adoption and market development could improve affordability.

PMID 42493387
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PubMedInternational endodontic journal2026-07-24

Association of the SCN9A rs6746030 (R1150W) Polymorphism on Inferior Alveolar Nerve Block Failure in Symptomatic Irreversible Pulpitis.

Aggarwal Vivek V, Gupta Alpa A, Singla Mamta M, Kumar Kapila K et al.

This study evaluated whether the SCN9A rs6746030 (G>A; R1150W) polymorphism is associated with the clinical success or failure of pulpal anaesthesia following an inferior alveolar nerve block (IANB). In this prospective clinical genetic association study, 320 patients with symptomatic irreversible pulpitis in mandibular molars were recruited. Each patient received a standardized IANB with 2% lidocaine and 1:80000 epinephrine. Anaesthesia was considered successful if the Heft-Parker Visual Analogue Scale (HP-VAS) score was below 54 mm during access cavity preparation/instrumentation; scores of 54 mm or higher were classified as failures. Buccal swab samples were collected for genotyping of rs6746030 using a TaqMan SNP assay. Genotype distributions were compared between the success and failure groups. Statistical analysis included Hardy-Weinberg equilibrium testing, chi-square comparisons, and binary logistic regression with genotype, age and gender as predictors. Out of 320 patients analysed, 199 experienced failed anaesthesia, while 121 achieved successful outcomes. A significant deviation from Hardy-Weinberg equilibrium was found in the failed anaesthesia group (p < 0.05), suggesting potential genetic influence, while the successful group showed no deviation (p = 0.99). Logistic regression revealed that patients with the AA genotype had significantly lower odds of successful anaesthesia (OR = 0.22; 95% CI: 0.049-0.993). No significant associations were observed for the GA genotype, age, or gender. The model's predictive ability was limited, with an AUC of 0.53. The rs6746030 polymorphism of SCN9A in its AA form is associated with a higher likelihood of IANB failure in mandibular molars with symptomatic irreversible pulpitis.

PMID 42495805
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