• Septic shock:
    • Titrate dose by 0.05-0.2mcg/kg/min every 10-15 min to target mean arterial pressure
  • Anaphylaxis:
    • Injectable form:
      • SC/IM 0.3-0.5mg (1mg/mL) every 5-10min PRN. Max: 0.5mg/dose OR IV 0.1-0.25mg (1mg/mL) every 5-10min PRN then IV 1-4mcg/min PRN
    • Pre-filled syringe (15-30 kg):
      • SC/IM 15mg x1
      • May repeat dose x1 after 5-15min
      • May consider SC/IM 0.3mg x1 if weight >25kg
    • Pre-filled syringe (>30kg):
      • SC/IM 0.3mg x1
      • May repeat dose x1 after 5-15 min
  • Severe asthma exacerbation:
    • SC/IM 0.3-0.5mg (1mg/mL) every 20 min for 3 doses PRN
    • Max: 1mg/dose
  • Symptomatic bradycardia:
    • IV infusion 2-10mcg/min (unresponsive to atropine or pacing) OR 1-0.5mcg/kg/min (7-35mcg/min in 70kg patient)
      • Titrate to patient response
  • Cardiac arrest:
    • IV:
      • 5-1.0mg (5-10mL)- recommended dose
      • 5mg (5mL) every 5min– during resuscitation
    • Endotracheal tube(ETT):
      • 2-2.5mg every 3-5min until IV/IO access established or spontaneous circulation restored
      • Used when IV line has not been established
  • Intracardiac:
    • 3-0.5mg (3-5mL)
  • Induction and maintenance of mydriasis during intraocular surgery:
    • Intraocular irrigating solution:
      • Dilute 1mg (of 1mg/mL single-use solution) to 1-10mcg/mL
    • Intraocular intracameral injection:
      • Dilute 1mg (of 1mg/mL single-use solution) to 2.5-10mcg/mL
      • Injection volume: 0.1 mL

Injection: 1mg/mL; 0.1mg/mL

Pre-filled syringe: 0.3mg

  • IV administration should only be done in patients who are profoundly hypotensive or are in cardiopulmonary arrest refractory to volume resuscitation and several epinephrine injections
  • Dilute ETT dose with sterile water or NS to total volume 5-10mL
  • IV/IO preferred to ETT route in cardiac arrest
  • Higher doses may be needed in if beta blocker or calcium channel blocker overdose

It stimulates alpha and beta adrenergic receptors, which cause an increase in cardio output and HR, a decrease in renal perfusion and PVR and a variable effect on BP. This causes systemic vasoconstriction and increased vascular permeability.

It also causes bronchial smooth muscle relaxation and secondary relaxation effects on smooth muscles of the stomach, intestine, uterus and urinary bladder

  • Palpitations
  • Tachycardia
  • Respiratory difficulty
  • Nausea
  • Vomiting
  • Pallor
  • Diaphoresis
  • Dizziness
  • Weakness
  • Tremor
  • Headache
  • Apprehension
  • Nervousness
  • Anxiety
  • Restlessness
  • IV use (auto-injector form)
  • Labor
  • DM
  • Non-anaphylactic shock
  • Narrow-angle glaucoma
  • Co-administration during general anesthesia with halogenated hydrocarbons or cyclopropane
  • Maternal blood pressure over 130/80 mmHg in hypertension and other cardiovascular disorders
  • Indapamide
  • Linezolid
  • Pentamidine
  • Procainamide
  • Quinidine
  • Beta blockers

                                   Drug Status

Availability Prescription only
Pregnancy Can be used in anaphylaxis (benefit outweighs risk)
Breastfeeding Can be used in anaphylaxis (benefit outweighs risk)
Schedule Not controlled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Adraz 1mg/mL Injection 10’s Zawadi Healthcare Zawadi Healthcare
Adrenaline 1mg/mL Injection 10’s Laborate India Harley’s Ltd
Adrenaline 0.1mg/mL Injection 10’s Laboratoire Renaudin Nairobi Pharma
Adrenaline 0.1mg/mL Pre-Filled Syringe 10mL*10’s Laboratoire Aguettant Phillips Therapeutics
Vasocon 1mg/mL Injection 10’s Neon Labs Ripple Pharma