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