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