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