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	Epinephrin (−)-3,4-dihydroxy-α-((methylamino)methyl)benzyl alcohol RACEPINEFRINE, (R)- (R)-(-)-Adrenaline (R)-(-)-Adnephrine Epinephrine Epinephrine bitartrate Adrénaline (R)-(-)-Epinephrine Adrenaline BENZYL ALCOHOL, 3,4-DIHYDROXY-.ALPHA.-((METHYLAMINO)METHYL)-, (-)- Epinephrinum (R)-(-)-Epirenamine 1,2-BENZENEDIOL, 4-(1-HYDROXY-2-(METHYLAMINO)ETHYL)-, (R)- (R)-(−)-adrenaline Epinefrina Levoepinephrine Epinephrine hydrochloride (−)-adrenaline Epinephrine acetate 4-((1R)-1-HYDROXY-2-(METHYLAMINO)ETHYL)-1,2-BENZENEDIOL L-Adrenaline (−)-(R)-epinephrine 4-[(1R)-1-Hydroxy-2-(methylamino)ethyl]-1,2-benzenediol Epinefrin
Brand Names	Xylocaine Epinephrine Injection USP Epinephrine Inj 0.1mg/ml USP Prilocaine HCl 4% Epineph 1:200000inj Xylocaine MPF E-pilo 4 Ophthalmic Solution Septocaine Orabloc 1:100,000 Taroclick Epinephrine Junior Taroclick Epinephrine Xylocaine with epinephrine Bupivacaine Hydrochloride with Epinephrine Adyphren Amp Kit Gingi-pak Max Z-twist No 3 Numbing Hemorrhoidal Label Septanest N Ana-kit 4% Citanest Forte Dental With Epinephrine 1:200,000 Ultracaine D-S Injection Allerject Epinephrine 0.3 Adults Xylocaine 1% W Epinephrine 1:200000 Adrenalin Topical Solution Adrenaclick 0.15mg Auto-injector LIDOCAINE HCl and EPINEPHRINE Xylocaine 0.5% W Epinephrine 1:100000 Ultacan LIDOCAINE HCl AND EPINEPHRINE Lidocaine Hci and Epinephrine Lidocaine 2% and Epinephrine 1:50,000 Emerade Lidocaine Hydrochloride 1.5% and Epinephrine 1:200000 Injection USP Octocaine HCl 2% Epinephrine 1:100000 Ultracaine DS Forte Inj Numquick Topical Analgesic 4% Astracaine Dental With Epinephrine 1:200,000 (0.005mg/ml) Lidocaine Hydrochloride and Epinephrine Bitartrate Taro-epinephrine Auto-injector Octocaine HCl 2% Epinephrine 1:50000 EPY Kit QKit Procedure Tray Certa Dose Epinephrine Convenience Kit E-pilo-4 Oph Soln Eurneffy SENSORCAINE MPF with Epinephrine Xylocaine 2% W Epinephrine 1:200000 Medihaler-Epi Epinephrine 1:1000 Inj 1mg/ml USP Gingi-pak Pellets Neffy Leep RediKit Pro Numb EpiPen Symjepi Lidocaine Hci Gingi-pak Max 2-ply Epinephrine Epinephrine Injection Articadent Gingi-pak Max Soft-twist No 2 Lidocaine Hydrochloride and Epinephrine EpinephrineSnap-V Xylocaine 2% W Epinephrine 1:100000 Bupivacaine HCl 0.5% and Epinephrine 1:200,000 Injection Vivacaine Articaine HCl and Epinephrine The Solution Marcaine E 0.25% Liq Prt Lidocaine 2% and Epinephrine 1:100,000 Bronkaid Mistometer Aem 0.5% EPY II Kit Prilocaine Hydrochloride with Epinephrine Xylocaine-mpf With Epi Epinephrine Professional EMS Lidosite Lidocaine Hydrochloride 1.5% and Epinephrine 1:200000 Injection USP Test Dose Primatene Mist Epinephrine Convenience Kit E-pilo 6 Ophthalmic Solution Articaine Hydrochloride and Epinephrine Bitartrate Injection Sensorcaine With Epinephrine Spinal Anaesthesia Tray Xylocaine 1.5% W Epinephrine 1:200000 Epi E-Z Pen - Liquid - 0.3mg/0.3ml Octocaine 100 Needleject Inj Epinephrine 0.15 Pediatrics Adrenalin Octocaine 50 Zorcaine Marcaine 0.5% and Epinephrine 1:200,000 Liq Sensorcaine Mpf Lignospan Speciale Inj Xylocaine Mpf 1.5% With Epinephrine Adrenaclick 0.30mg Auto-injector Epinephrine Chloride Solution Dentsply 4% Prilocaine and Epinephrine Injection 1:200,000 Deluxe Dental Emergency Kit Ana-kit (2mg/tab Orl, 1mg/ml Liq Sc Im) Septocaine and Epinephrine EpinephrineSnap-EMS Twinject 0.15mg Auto-injector Adrenalin Vials Citanest Forte Lignospan Standard Dentsply 2% Lidocaine With Epinephrine 1:100,000 Orabloc 1:200,000 D-Care 100X Blue Gel Anesthetic Lidocaine Lixtraxen 1% Sensorcaine(r) (bupivacaine Hci and Epinephrine) Gingi Pak Cord No 1 Epinephrine Professional E-pilo-6 Oph Soln Ultacan Forte LIDOCAINE HCl AND EPI Xylocaine Dental Lidocaine HCl 2% and Epinephrine 1:100,000 Zone 2 Adrenalin(r) Sensorcaine Forte Adrenalin (epinephrine) Sensorcaine Bupivacaine Hydrochloride and Epinephrine Xylocaine 1% W Epinephrine 1:100000 Scandonest 2% Special Inj Marcaine Xylocaine 2% With Epinephrine 1:200000 Gold Label Anorectal Numbing Spray Epinephrine Pediatrics Xylocaine(r) -mpf (lidocaine Hci and Epinephrine) Adrenaclick E-pilo-2 Oph Soln Septanest Sp Gingi-pak Max Z-twist No 00 Marcaine E Articaine Hydrochloride and Epinephrine E-pilo 2 Ophthalmic Solution Xylocaine 0.5% W Epinephrine 1:200000 Epipen Jr Dysne Inhal Lidocaine Hydrochloride 0.5% and Epinephrine 1:200000 Injection USP Posicaine Sp Anapen Junior Orabloc Octocaine 100 Auvi-Q Lidocaine and Epinephrine Inj.usp 2% 1:100000 Adrenalin (epinephrine in sodium chloride) Numquick Analgesic CLIN-LIDO-Single Use Kit Ultracaine D-S Forte Injection Marcaine E Liq Prt 0.50% Orostat 8% Lidocaine Hydrochloride and Epinephrine Injection USP Xylocaine Dental Lidocaine Hydrochloride 2% and Epinephrine 1:50,000 Spinal Anesthesia Tray The Solution Anorectal Spray Temporary Pain Relief Adyphren II Kit EPIsnap Epinephrine Convenience Kit Gingi-pak Max Z-twist No 2 Twinject Anakit Insect Sting Treatment Kit Adyphren Amp II Kit Ultracaine DS Inj Twinject 0.3mg Auto-injector Primatene Mist Refill Articaine 2% Lidocaine and Epinephrine 1:100,000 Injection USP Pro Numb Sensitive Skin E-pilo 1 Ophthalmic Solution Gingi-pak Cotton Coil Epinephrinesnap-V Lidocaine Hci and Epinephrine With Epinephrine LIDOCAINE HCl EpiPen Jr Ephinephrine Bupivacaine Hci and Epinephrine Gingi-pak Max Soft-twist No 3 E-pilo-1 Oph Soln Xylocaine 1.5% W Epinephrine 1:200000 Test Dose Marcaine with Epinephrine Lidocaine 2% and Epinephrine 1:50 000 Citanest Forte DENTAL Posicaine N Lidocaine 2% and Epinephrine 1:100 000 Lignospan Forte Epinephrine Injection USP 1 mg/ml Dentsply 2% Lidocaine With Epinephrine 1:50,000 Gingi-pak Max Soft-twist No 1 Prime Asthma Relief Gingi-pak Max Z-twist No 1 Crown-pak Max 4-ply Marcaine With Epinephrine Vasocaine 4% Astracaine Dental With Epinephrine Forte 1:100,000 (0.01mg/ml) Adyphren Kit Anapen Minnerva II Basic Dental Emergency Kit Epipen
Indication	Epinephrine injection and nasal spray are indicated in the emergency treatment of type I allergic reactions, including anaphylaxis.[L41260, L51798] 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