Drug Database
EP

epinephrine (Emerade)

✓ Approved

Bausch + Lomb Corporation · Small Molecule · Small Molecule

What is epinephrine?

epinephrine is a small molecule developed by Bausch + Lomb Corporation. It is approved for therapeutic indications via injectable (others).

Drug Profile

Brand NamesEmerade
CompanyBausch + Lomb Corporation
Drug ClassSmall Molecule
RouteInjectable (Others)
StatusApproved
Sources: ClinicalTrials.gov, Bausch + Lomb Corporation

Therapeutic Indications

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

Therapeutic AreaConditionPhase
Immune system disordersAnaphylactic reaction✓ Approved

Related Research Articles

PubMedTrials2026-06-09

Evaluating intramuscular epinephrine in pediatric out-of-hospital cardiac arrest (the PRIME trial): study protocol for a multi-centre, stepped-wedge cluster quasi-randomized controlled trial.

Idrees Samina S, Assaf Maysaa M, Davis Matthew M, Garcia-Bournissen Facundo F et al.

Pediatric out-of-hospital cardiac arrest (POHCA) is a time-sensitive event with a high mortality rate. Epinephrine is a key first-line medication used during cardiac arrest resuscitation to support perfusion and return of spontaneous circulation (ROSC). Guidelines for the management of POHCA recommend paramedics administer epinephrine as soon as possible by intravenous (IV) or intraosseous (IO) injection. However, successfully inserting an IV or IO line can be challenging in high-stress situations, particularly in a poorly perfused, small child. In contrast, intramuscular (IM) epinephrine, which is the standard of care in anaphylaxis management, does not require paramedics to secure vascular access and may lead to a shorter time to first dose. The POHCA Resuscitation: Evaluation of IM Epinephrine (PRIME) trial aims to evaluate the impact of IM epinephrine on POHCA outcomes. The primary objective of the PRIME trial is to determine if an initial dose of IM epinephrine improves time to return of spontaneous circulation (ROSC) compared to standard of care alone. The PRIME trial is a prospective, multi-centre, pragmatic, two-arm, open-label, stepped-wedge cluster quasi-randomized controlled trial. We will randomize at the level of the paramedic service, as individual-level randomization is not possible due to the inclusion of multiple, heterogeneous regions. Each site will serve as its own control. This study is a regional trial, with a focus on limited efficacy testing through an intermediate outcome (i.e., time to ROSC) that is strongly associated with survival. We also aim to evaluate the impact of the intervention on survival to hospital discharge, survival to hospital discharge with favourable neurological outcome, and safety in POHCA management. The PRIME trial aims to provide insight into the effectiveness and safety of IM epinephrine in POHCA. The data and analyses generated from the trial have the potential to inform resuscitation guidelines and standard of care practices. ClinicalTrials.gov NCT05166343, Registered on December 8, 2021.

PMID 42260675
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PubMedJournal of the American Chemical Society2026-06-09

Enantiodivergent Construction of Oxa-Quaternary Carbon Centers via Desymmetrization Based on Palladium/Chiral Norbornene Cooperative Catalysis.

Sun Zhongliu Z, Ye Jinxiang J, Zhang Qian Q, Wang Jianshu J et al.

Oxa-quaternary carbon centers are prevalent in bioactive natural products and pharmaceuticals. However, the development of general and practical methods to construct these oxa-quaternary carbon stereocenters remains a formidable challenge. Herein, we report a desymmetrization strategy for the construction of oxa-quaternary carbon stereocenters based on palladium/chiral norbornene cooperative catalysis. With readily available aryl iodides and prochiral 2'-bromo-aryl-substituted tertiary alcohols as the building blocks, a wide variety of 6H-benzo[c]chromenes bearing an oxa-quaternary carbon stereocenter and a versatile C-Br bond are expediently prepared in a highly enantioselective manner (43 examples, up to 99% e.e.). Notably, both enantiomers can be stereodivergently obtained through a simple switch of the same configurated chiral NBE cocatalysts. The synthetic utility of this method is demonstrated by a successful scale-up experiment and diverse late-stage structural modifications through the facile elaboration of the common C-Br bond of the obtained chiral 6H-benzo[c]chromene products. In addition to the experimental studies, DFT calculations are performed to elucidate the reaction mechanism, the origin of enantiodiscrimination, and enantioselectivity inversion in this desymmetrization process.

PMID 42262073
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PubMedAmerican journal of disaster medicine2026-06-09

Pharmacy operations within the Japan Disaster Relief (JDR) medical team during the 2025 Myanmar Earthquake: Practices, challenges, and lessons learned.

Egawa Takashi T, Yamauchi Takashi T, Masuda Yumiko Y, Oba Jiro J et al.

To document and analyze the medical relief activities conducted following the 2025 Myanmar Earthquake and to contribute to the improvement of international disaster medical response frameworks. This is a descriptive qualitative study. Disaster site in central Myanmar. In response to the extensive damage caused by the earthquake, the Government of Japan deployed a Japan Disaster Relief (JDR) medical team to Myanmar. This decision was made following the identification of urgent medical needs. The pharmaceutical responses of the JDR medical team to the Myanmar Earthquake were reviewed. Pharmacists pharmaceutical interventions in the context of disaster medical care extracted from daily activity reports, dispensing records, and chronological logs maintained by the medical team. Following the JDR medical teams pharmaceutical response, pharmacists protocol-based pharmacotherapy management (PBPM) in collaboration with physicians was enacted prior to the start of medical activities. Pharmacy roles were equitably distributed between dispensing and providing support to other professionals. The use of pictorial aids enabled pharmacists to effectively communicate medication instructions. Points for improvement include ensuring the quality of the cold chain for cold-stored pharmaceuticals and reviewing the list of topical medications according to the type of disaster. PBPM has emerged as an effective approach that allows pharmacists to assist in prescription management under predefined protocols, potentially reducing physician workload. The application of task shifting and sharing serves as a pragmatic strategy for the redistribution of clinical responsibilities, thereby enabling a more efficient deployment of limited medical personnel in disaster response settings.

PMID 42262276
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PubMedEuropean journal of pediatrics2026-06-09

Novelties in the pragmatic management of anaphylaxis in pediatric age.

Marseglia Gian Luigi GL, Tosca Maria Angela MA, Miraglia Del Giudice Michele M, Manti Sara S et al.

Anaphylaxis is a time-critical, potentially fatal systemic hypersensitivity reaction. This narrative review summarizes recent advances in the diagnosis and management of anaphylaxis in children and adolescents, with emphasis on new diagnostic frameworks, improved self-management strategies, intranasal adrenaline, and disease-modifying therapies. A narrative review was conducted using PubMed and MEDLINE, focusing on articles and guidelines published between January 2020 and March 2026. Search terms included "anaphylaxis", "pediatric anaphylaxis", "adrenaline", "epinephrine", "autoinjector", "intranasal adrenaline", "food anaphylaxis", "omalizumab", and "oral immunotherapy". International guidelines, consensus documents, systematic reviews, pharmacokinetic studies, and pediatric studies were prioritized. Food remains the leading trigger in children, but drug, Hymenoptera venom, cofactor-dependent, and non-IgE-mediated mechanisms must be systematically considered. Adrenaline is underused in community settings despite being the only life-saving drug. Intranasal adrenaline represents the most visible delivery innovation: it may reduce needle-related barriers and simplify administration, but current evidence is largely based on pharmacokinetic/pharmacodynamic studies and limited pediatric clinical data. Omalizumab and oral immunotherapy are reshaping long-term risk reduction in food allergy but do not remove the need for emergency adrenaline. The pragmatic management of anaphylaxis in children and adolescents entails self-management and hospital-based care. Intramuscular adrenaline is the first-line treatment when anaphylaxis is ongoing or recurrent, whereas adjunctive therapies should be considered on clinical grounds. Discharge recommendations should be individualized and include structured education, risk assessment, emergency planning and specialist follow-up. Intranasal adrenaline is a promising innovation, but its introduction requires clinical positioning, pharmacovigilance, cost-effectiveness evaluation, and continued emphasis on early treatment. • Intramuscular adrenaline is the first-line treatment for anaphylaxis and should not be delayed. • Food is the leading trigger in children, while drugs, venom, and cofactors become more relevant with age. • Intranasal adrenaline is a promising needle-free option, but pediatric evidence remains limited. • Omalizumab and oral immunotherapy may reduce risk but do not replace emergency preparedness.

PMID 42262574
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PubMedScientific reports2026-06-09

The cost-effectiveness of inventory reserves for preventing drug shortages in Germany: a health-economic evaluation.

Gandjour Afschin A

Based on a recent legislative change in Germany, maintaining a six-month inventory reserve for pharmaceuticals has become the primary strategy used by the German government to prevent shortages and stockouts. This study aimed to estimate the number of drug shortages preventable under the medicines stockpiling mandate and to determine the maximum stockpiling duration that remains cost-effective. The study adopted the perspective of the German social health insurance and analyzed a publicly available database containing information on all past drug shortages in Germany from the first entry in 2012 to May 2023 (n = 2768). The proportion of preventable drug shortages was estimated as a function of inventory duration. Additionally, secondary data were used to ascertain the costs associated with inventory carrying (including storage, capital, and expiration costs) and the gain in quality-adjusted life years (QALYs) resulting from avoiding relevant shortages of medication packages. Maintaining a six-month inventory could prevent approximately 70% of drug shortages. The empirical analysis revealed a diminishing incremental benefit of extending the drug supply duration, leading to an increasing marginal cost-per-QALY ratio. Based on a health opportunity cost-based cost-effectiveness threshold, the cost-effective upper limit of inventory duration under the current assumptions was approximately 922 days. This estimate was particularly sensitive to assumptions about FIFO ("first in, first out") warehouse procedures, number of drug shortages, and the valuation of health gains. This study indicates that Germany's recently introduced six-month inventory mandate could substantially reduce drug shortages and deliver good value for money, with a very high probability of cost-effectiveness across the willingness-to-pay thresholds examined in the sensitivity analysis. However, key uncertainties-especially around FIFO procedure compliance, health opportunity costs, and the clinical consequences of shortages-warrant ongoing monitoring and periodic reassessment as new evidence becomes available.

PMID 42259934
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PubMedPaediatric anaesthesia2026-06-09

Role of Angiotensin II as a Vasoactive Agent to Treat Distributive Shock With a Focus on Preliminary Data in Pediatric-Aged Patients.

Ito Shinya S, Spellman Kevin K, Khan Sarah S, Tobias Joseph D JD

In pediatric-aged patients, distributive (vasoplegic) shock is commonly caused by sepsis, anaphylaxis, or the humoral/immunologic response following cardiopulmonary bypass. In general, the first-line vasoactive agent for children is epinephrine or norepinephrine. In cases of fluid-refractory shock requiring escalating doses of catecholamines, adjunct therapies such as vasopressin, hydrocortisone, hydroxycobalamin-ascorbic acid, and methylene blue may be introduced. In 2017, the FDA approved a synthetic human angiotensin II (AT-II) infusion preparation for treating adult patients with refractory vasodilatory shock. The following educational review examines the role of AT-II as a vasoactive agent in the treatment of distributive shock with a focus on pediatric patients. A systematic search of the literature was performed to identify key publications regarding the therapeutic use of AT-II for the treatment of distributive shock in adult and pediatric patients. Prospective studies in adult patients demonstrate the efficacy of AT-II to treat refractory vasodilatory shock when escalating doses of conventional vasoactive agents (norepinephrine ≥ 0.2-0.3 μg/kg/min) have failed. In these scenarios, AT-II has been added as the third or fourth medication. There are limited trials evaluating AT-II as the primary agent for vasodilatory shock in adults. The majority of studies have shown an improvement in mean arterial pressure (MAP); however, there has been limited impact on long-term survival. Pediatric evidence to date has included 5 case reports and two larger retrospective case series encompassing a total of 44 patients. Although AT-II was generally effective in increasing the MAP, given the non-randomized and non-prospective nature of these studies, information regarding the impact on long-term outcomes is not available. Both adult and pediatric reports have outlined the potential utility of AT-II in treating vasodilatory shock as primarily a rescue agent when conventional vasoactive agents fail or dose requirements escalate. To date, evidence-based medicine demonstrates an increase in MAP with the ability to wean other vasoactive agents. The current studies do not appear to uniformly and clearly define a survival benefit. Future studies should focus on the potential survival impact of this novel vasoactive agent, further define dosing strategies, and more clearly outline its role as a primary agent or when other vasoactive agents fail.

PMID 42261794
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