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