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