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