ALE

L-EPINEPHRINE

Created:	1999-07-08
Last modified:	2021-03-01

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Chemical Details
Formal Charge	0
Atom Count	26
Chiral Atom Count	1
Bond Count	26
Aromatic Bond Count	6

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Chemical Component Summary
Name	L-EPINEPHRINE
Synonyms	ADRENALINE
Systematic Name (OpenEye OEToolkits)	4-[(1R)-2-(methylamino)-1-oxidanyl-ethyl]benzene-1,2-diol
Formula	C₉ H₁₃ N O₃
Molecular Weight	183.204
Type	NON-POLYMER

Chemical Descriptors
Type	Program	Version	Descriptor
SMILES	ACDLabs	12.01	Oc1ccc(cc1O)C(O)CNC
SMILES	CACTVS	3.370	CNC[CH](O)c1ccc(O)c(O)c1
SMILES	OpenEye OEToolkits	1.7.6	CNCC(c1ccc(c(c1)O)O)O
Canonical SMILES	CACTVS	3.370	CNC[C@H](O)c1ccc(O)c(O)c1
Canonical SMILES	OpenEye OEToolkits	1.7.6	CNC[C@@H](c1ccc(c(c1)O)O)O
InChI	InChI	1.03	InChI=1S/C9H13NO3/c1-10-5-9(13)6-2-3-7(11)8(12)4-6/h2-4,9-13H,5H2,1H3/t9-/m0/s1
InChIKey	InChI	1.03	UCTWMZQNUQWSLP-VIFPVBQESA-N

Drug Info: DrugBank

DrugBank data are sourced from datasets licensed under a Creative Common's Attribution-NonCommercial 4.0 International License

DrugBank ID	DB00668
Name	Epinephrine
Groups	investigational vet_approved approved
Description	Epinephrine, also known as _adrenaline_, is a hormone and neurotransmitter and produced by the adrenal glands that can also be used as a drug due to its various important functions. Though it has long been used in the treatment of hypersensitivity reactions, epinephrine in the auto-injector form (EpiPen) has been available since 1987 in the USA. Many new products/biosimilars and dosage routes have been approved under various names over the last several decades [L4355], [L4356], [L4358]. On August 16, 2018, Teva Pharmaceuticals USA gained approval to market its generic epinephrine auto-injector in 0.3 mg and 0.15 mg strengths [L4353]. Dosage delivery routes for epinephrine include intravenous, inhalation, nebulization, intramuscular injection, and subcutaneous injection. In general, the most common uses of parenteral epinephrine are to relieve respiratory distress due to bronchospasm, to provide rapid relief of hypersensitivity (anaphylactic or anaphylactoid) reactions to drugs, animal serums and other allergens, and to prolong the action of infiltration anesthetics [F2136]. In addition to the above functions, epinephrine is the primary drug administered during cardiopulmonary resuscitation (CPR) to reverse cardiac arrest [A37697], [A37699]. It can be used in severe cases of croup [L4824].
Synonyms	(−)-adrenaline Epinephrine bitartrate Epinephrin (−)-3,4-dihydroxy-α-((methylamino)methyl)benzyl alcohol RACEPINEFRINE, (R)- BENZYL ALCOHOL, 3,4-DIHYDROXY-.ALPHA.-((METHYLAMINO)METHYL)-, (-)- Adrenaline Adrénaline Epinephrine (R)-(-)-Epirenamine Epinephrinum (R)-(−)-adrenaline (R)-(-)-Adnephrine Epinephrine acetate Epinefrina (R)-(-)-Adrenaline (R)-(-)-Epinephrine Levoepinephrine (−)-(R)-epinephrine 1,2-BENZENEDIOL, 4-(1-HYDROXY-2-(METHYLAMINO)ETHYL)-, (R)- 4-((1R)-1-HYDROXY-2-(METHYLAMINO)ETHYL)-1,2-BENZENEDIOL L-Adrenaline Epinefrin 4-[(1R)-1-Hydroxy-2-(methylamino)ethyl]-1,2-benzenediol Epinephrine hydrochloride
Brand Names	E-pilo 2 Ophthalmic Solution CLIN-LIDO-Single Use Kit Ultracaine DS Inj Medihaler-Epi Xylocaine with epinephrine Xylocaine 1% W Epinephrine 1:200000 Citanest Forte DENTAL 4% Astracaine Dental With Epinephrine Forte 1:100,000 (0.01mg/ml) Xylocaine 1% W Epinephrine 1:100000 Gingi-pak Max Soft-twist No 1 Anakit Insect Sting Treatment Kit Lidocaine Hydrochloride 1.5% and Epinephrine 1:200000 Injection USP Emerade Lidocaine Hydrochloride 1.5% and Epinephrine 1:200000 Injection USP Test Dose EpiPen QKit Procedure Tray Epinephrine 0.3 Adults Octocaine 100 Needleject Inj EPY Kit Pro Numb Xylocaine-mpf With Epi Adrenaclick 0.15mg Auto-injector Zorcaine Vasocaine Zone 2 Octocaine HCl 2% Epinephrine 1:100000 Sensorcaine(r) (bupivacaine Hci and Epinephrine) Marcaine with Epinephrine Epipen Jr Articaine Ephinephrine Numbing Hemorrhoidal Label Numquick Topical Analgesic Scandonest 2% Special Inj LIDOCAINE HCl and EPINEPHRINE Numquick Analgesic Vivacaine 2% Lidocaine and Epinephrine 1:100,000 Injection USP Spinal Anesthesia Tray EpinephrineSnap-V Epinephrine Injection Lidocaine Hydrochloride 0.5% and Epinephrine 1:200000 Injection USP EPY II Kit Orabloc Dentsply 2% Lidocaine With Epinephrine 1:50,000 Marcaine E Leep RediKit Gingi-pak Max Soft-twist No 2 Lidocaine Hci E-pilo 1 Ophthalmic Solution Adrenalin Topical Solution Prime Asthma Relief Gold Label Anorectal Numbing Spray Lidocaine 2% and Epinephrine 1:50,000 4% Astracaine Dental With Epinephrine 1:200,000 (0.005mg/ml) Twinject 0.15mg Auto-injector Octocaine HCl 2% Epinephrine 1:50000 Articaine Hydrochloride and Epinephrine Bitartrate Injection Anapen Junior Xylocaine MPF Xylocaine 2% With Epinephrine 1:200000 LIDOCAINE HCl AND EPINEPHRINE Xylocaine Mpf 1.5% With Epinephrine Xylocaine 1.5% W Epinephrine 1:200000 Marcaine With Epinephrine Sensorcaine Forte Lidocaine Hydrochloride and Epinephrine Adrenalin (epinephrine) Epinephrinesnap-V Epinephrine Injection USP Adyphren Kit Epipen Ana-kit (2mg/tab Orl, 1mg/ml Liq Sc Im) Dysne Inhal Xylocaine 2% W Epinephrine 1:100000 Adyphren Amp Kit Neffy Gingi-pak Max Z-twist No 00 Bupivacaine Hci and Epinephrine Crown-pak Max 4-ply Xylocaine 0.5% W Epinephrine 1:200000 E-pilo-1 Oph Soln Xylocaine 1.5% W Epinephrine 1:200000 Test Dose Pro Numb Sensitive Skin Sensorcaine With Epinephrine Xylocaine 0.5% W Epinephrine 1:100000 Octocaine 50 Gingi-pak Cotton Coil Minnerva II Epinephrine Injection USP 1 mg/ml Orabloc 1:200,000 Ultacan Forte Gingi-pak Max Z-twist No 1 Certa Dose Epinephrine Convenience Kit Primatene Mist SENSORCAINE MPF with Epinephrine Epinephrine Inj 0.1mg/ml USP Articaine HCl and Epinephrine Gingi-pak Max Z-twist No 2 Dentsply 4% Prilocaine and Epinephrine Injection 1:200,000 Lidocaine Hci and Epinephrine With Epinephrine EPIsnap Epinephrine Convenience Kit Lidosite Ultracaine D-S Injection Symjepi Prilocaine Hydrochloride with Epinephrine Bupivacaine Hydrochloride with Epinephrine E-pilo 6 Ophthalmic Solution Primatene Mist Refill Taroclick Epinephrine Septocaine Articaine Hydrochloride and Epinephrine D-Care 100X Ultracaine D-S Forte Injection Ana-kit The Solution Anorectal Spray Temporary Pain Relief Xylocaine Adrenalin Epinephrine Convenience Kit Sensorcaine Mpf Twinject 0.3mg Auto-injector Eurneffy Adyphren Amp II Kit Deluxe Dental Emergency Kit Gingi-pak Max Z-twist No 3 Lidocaine and Epinephrine Inj.usp 2% 1:100000 Bupivacaine HCl 0.5% and Epinephrine 1:200,000 Injection Epinephrine Professional EMS E-pilo 4 Ophthalmic Solution Adrenalin (epinephrine in sodium chloride) Octocaine 100 Twinject EpinephrineSnap-EMS Epinephrine Chloride Solution Blue Gel Anesthetic Marcaine 0.5% and Epinephrine 1:200,000 Liq Gingi-pak Max 2-ply Epinephrine 1:1000 Inj 1mg/ml USP 4% Citanest Forte Dental With Epinephrine 1:200,000 E-pilo-4 Oph Soln Anapen Posicaine N Gingi-pak Pellets Epinephrine Pediatrics Bronkaid Mistometer Aem 0.5% Auvi-Q Lixtraxen 1% Taroclick Epinephrine Junior Dentsply 2% Lidocaine With Epinephrine 1:100,000 Lignospan Speciale Inj Lidocaine Xylocaine Dental Lidocaine Hydrochloride 2% and Epinephrine 1:50,000 Lidocaine Hci and Epinephrine Flavalta Adrenalin Vials E-pilo-2 Oph Soln Posicaine Sp Septocaine and Epinephrine LIDOCAINE HCl AND EPI Orostat 8% Prilocaine HCl 4% Epineph 1:200000inj Lidocaine 2% and Epinephrine 1:100,000 Allerject Marcaine E 0.25% Liq Prt Articadent Lidocaine Hydrochloride and Epinephrine Bitartrate EpiPen Jr E-pilo-6 Oph Soln Adrenaclick 0.30mg Auto-injector Gingi-pak Max Soft-twist No 3 Citanest Forte Septanest Sp Xylocaine(r) -mpf (lidocaine Hci and Epinephrine) Adrenalin(r) LIDOCAINE HCl Xylocaine Dental Lidocaine HCl 2% and Epinephrine 1:100,000 Adyphren II Kit Septanest N Epinephrine Professional Ultracaine DS Forte Inj Lidocaine Hydrochloride and Epinephrine Injection USP Adrenaclick Lignospan Standard Taro-epinephrine Auto-injector Spinal Anaesthesia Tray Epinephrine 0.15 Pediatrics Epi E-Z Pen - Liquid - 0.3mg/0.3ml Marcaine E Liq Prt 0.50% Epinephrine Bupivacaine Hydrochloride and Epinephrine Lidocaine 2% and Epinephrine 1:50 000 The Solution Basic Dental Emergency Kit Marcaine Sensorcaine Gingi Pak Cord No 1 Orabloc 1:100,000 Xylocaine 2% W Epinephrine 1:200000 Lignospan Forte Lidocaine 2% and Epinephrine 1:100 000 Ultacan
Indication	Epinephrine injection and nasal spray are indicated in the emergency treatment of type I allergic reactions, including anaphylaxis.[L41260, L51798, L56117] Epinephrine injection is also used to increase mean arterial blood pressure in adult patients with hypotension associated with septic shock.[L41260] Epinephrine's cardiac effects may be of use in restoring cardiac rhythm in cardiac arrest due to various causes but is not used in cardiac failure or in hemorrhagic, traumatic, or cardiogenic shock [F1247]. Epinephrine is used as a hemostatic agent. It is so used in treating mucosal congestion of hay fever, rhinitis, and acute sinusitis; to relieve bronchial asthmatic paroxysms; in syncope due to complete heart block or carotid sinus hypersensitivity; for symptomatic relief of serum sickness, urticaria, angioneurotic edema; for resuscitation in cardiac arrest following anesthetic accidents; in simple (open-angle) glaucoma; for relaxation of uterine musculature and to inhibit uterine contractions. Epinephrine injection can be utilized to prolong the action of local anesthetics [F1247]. In addition to the above, epinephrine is used as an over the counter (OTC) agent for the intermittent symptoms of asthma, such as wheezing, tightness of chest and shortness of breath [F2131]. It is also used for the maintenance of mydriasis during intraocular surgery [L4825].
Categories	Adrenergic Agents Adrenergic Agonists Adrenergic alpha-1 Receptor Agonists Adrenergic alpha-2 Receptor Agonists Adrenergic alpha-Agonists Adrenergic and Dopaminergic Agents Adrenergic beta-1 Receptor Agonists Adrenergic beta-2 Receptor Agonists Adrenergic beta-3 Receptor Agonists Adrenergic beta-Agonists Adrenergics, Inhalants Agents producing tachycardia Agents that produce hypertension Alpha-and Beta-adrenergic Agonists Amines Anti-Asthmatic Agents Antiglaucoma Preparations and Miotics Autonomic Agents Benzene Derivatives Biogenic Amines Biogenic Monoamines Bronchodilator Agents Cardiac Stimulants Excl. Cardiac Glycosides Cardiac Therapy Cardiovascular Agents Catecholamines Catechols COMT Substrates Cytochrome P-450 CYP2C9 Inhibitors Cytochrome P-450 CYP2C9 Inhibitors (strength unknown) Cytochrome P-450 CYP3A Inhibitors Cytochrome P-450 CYP3A4 Inhibitors Cytochrome P-450 CYP3A4 Inhibitors (strength unknown) Cytochrome P-450 Enzyme Inhibitors Dental Agents Drugs for Obstructive Airway Diseases Epinephrine and similars Hemostatics Hyperglycemia-Associated Agents Local Hemostatics Mydriatics Nasal Preparations Neurotransmitter Agents OCT1 substrates OCT2 Substrates Ophthalmologicals Peripheral Nervous System Agents Phenols Respiratory System Agents Stomatological Preparations Sympathomimetic (Adrenergic) Agents Sympathomimetics Sympathomimetics in Glaucoma Therapy Sympathomimetics, Plain Vasoconstrictor Agents
ATC-Code	A01AD01 R03AK01 B02BC09 C01CA24 S01EA01 R01AA14 R03AA01 S01EA51
CAS number	51-43-4

Drug Targets

DrugBank data are sourced from datasets licensed under a Creative Common's Attribution-NonCommercial 4.0 International License

Name	Target Sequence	Pharmacological Action	Actions
Alpha-1A adrenergic receptor	MVFLSGNASDSSNCTQPPAPVNISKAILLGVILGGLILFGVLGNILVILS...	unknown	agonist
Alpha-1B adrenergic receptor	MNPDLDTGHNTSAPAHWGELKNANFTGPNQTSSNSTLPQLDITRAISVGL...	unknown	agonist
Beta-1 adrenergic receptor	MGAGVLVLGASEPGNLSSAAPLPDGAATAARLLVPASPPASLLPPASESP...	unknown	agonist
Beta-2 adrenergic receptor	MGQPGNGSAFLLAPNGSHAPDHDVTQERDEVWVVGMGIVMSLIVLAIVFG...	unknown	agonist
Alpha-2A adrenergic receptor	MFRQEQPLAEGSFAPMGSLQPDAGNASWNGTEAPGGGARATPYSLQVTLT...	unknown	agonist
Alpha-2B adrenergic receptor	MDHQDPYSVQATAAIAAAITFLILFTIFGNALVILAVLTSRSLRAPQNLF...	unknown	agonist
Alpha-1D adrenergic receptor	MTFRDLLSVSFEGPRPDSSAGGSSAGGGGGSAGGAAPSEGPAVGGVPGGA...	unknown	antagonist
Tumor necrosis factor	MSTESMIRDVELAEEALPKKTGGPQGSRRCLFLSLFSFLIVAGATTLFCL...	unknown	antagonist,agonist
Cytochrome P450 2C9	MDSLVVLVLCLSCLLLLSLWRQSSGRGKLPPGPTPLPVIGNILQIGIKDI...	unknown	inhibitor
Cytochrome P450 3A4	MALIPDLAMETWLLLAVSLVLLYLYGTHSHGLFKKLGIPGPTPLPFLGNI...	unknown	inhibitor
Catechol O-methyltransferase	MPEAPPLLLAAVLLGLVLLVVLLLLLRHWGWGLCLIGWNEFILQPIHNLL...	unknown	substrate
Monoamine oxidase	MENQEKASIAGHMFDVVVIGGGISGLSAAKLLTEYGVSVLVLEARDRVGG...	unknown	substrate
Solute carrier family 22 member 2	MPTTVDDVLEHGGEFHFFQKQMFFLLALLSATFAPIYVGIVFLGFTPDHR...	unknown	substrate
Solute carrier family 22 member 1	MPTVDDILEQVGESGWFQKQAFLILCLLSAAFAPICVGIVFLGFTPDHHC...	unknown	substrate
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Drug Info/Drug Targets: DrugBank 3.0: a comprehensive resource for 'omics' research on drugs. Knox C, Law V, Jewison T, Liu P, Ly S, Frolkis A, Pon A, Banco K, Mak C, Neveu V, Djoumbou Y, Eisner R, Guo AC, Wishart DS. Nucleic Acids Res. 2011 Jan; 39 (Database issue):D1035-41. | PMID:21059682