Epinephrine
Also known as: Adrenalin, EpiPen, Twinject, Adrenaline, Epinephrine
Epinephrine is a life-saving emergency medication used for severe allergic reactions (anaphylaxis). * **Emergency Use Only:** If you have been prescribed pre-loaded syringes (like an EpiPen) for your pet, use it *only* for known, severe allergic reactions as directed by your veterinarian. * **Seek Immediate Care:** Even after administering epinephrine, you must take your pet to a veterinary emergency clinic immediately. The drug wears off quickly, and the allergic reaction may return. * **Administration:** Ensure you understand the proper injection technique (usually into the muscle or under the skin) demonstrated by your vet. * **Storage:** Store at room temperature away from light. **Do not use** the medication if it is past its expiration date, if the liquid has turned pink or brown, or if you see particles floating in it.
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
What it is used for
- Anaphylaxis
- Anaphylaxis
- Cardiac resuscitation (asystole)
- Cardiac resuscitation
- Cardiac resuscitation
- Neonatal resuscitation (when respiratory support/compressions fail)
- Anaphylaxis
- Anaphylaxis
- Bronchoconstriction
- Hypotension associated with anesthesia
- Hypotension associated with anesthesia
- Cardiopulmonary arrest (CPA)
- Bronchoconstriction and anaphylaxis
- Emergency management
How it is given
Possible side effects
- Anxiety and fear
- Tremors and excitability
- Vomiting
- Hypertension (especially with overdosage)
- Cardiac arrhythmias (especially with pre-existing heart disease)
- Hyperuricemia
- Lactic acidosis (with prolonged use or overdose)
- Tissue necrosis and sloughing at the injection site (with repeated injections or injection into small appendages)
Cautions & contraindications
- Narrow-angle glaucoma
- Hypersensitivity to epinephrine
- Shock due to non-anaphylactoid causes
- During general anesthesia with halogenated hydrocarbons or cyclopropane
- During labor (may delay the second stage)
- Cardiac dilatation or coronary insufficiency
- Conditions where vasopressors are contraindicated (e.g., thyrotoxicosis, diabetes, hypertension, toxemia of pregnancy)
- Injection with local anesthetics into small appendages (toes, ears, etc.) due to risk of necrosis
- **Hypovolemia:** Epinephrine is not a substitute for adequate fluid volume replacement therapy. **Cardiac Rhythms:** Use with extreme caution in patients with a prefibrillatory cardiac rhythm due to excitatory effects on the heart. While useful in asystole, it can cause ventricular fibrillation; use cautiously in cases of existing ventricular fibrillation. **Tissue Necrosis:** Do not inject into small appendages (ears, toes, tails) as profound vasoconstriction can cause ischemic necrosis and sloughing. **Concentration Errors:** Always double-check the concentration (1:1,000 vs 1:10,000) before administration to avoid fatal overdoses.
Drug interactions
- Alpha-blockers (phentolamine, phenoxybenzamine, prazosin): May negate the therapeutic effects of epinephrine.
- Alpha-2 agonists (detomidine, dexmedetomidine, xylazine): Do NOT use epinephrine to treat cardiac effects caused by alpha-2 agonists; may worsen hemodynamics.
- General Anesthetics (halogenated hydrocarbons, cyclopropane): Increased risk of developing severe arrhythmias. Propranolol may be used to treat if they occur.
- Antihistamines (diphenhydramine, chlorpheniramine): May potentiate the effects of epinephrine.
- Beta-blockers (propranolol): May potentiate hypertension and antagonize epinephrine's cardiac and bronchodilating effects.
- Digoxin: Increased risk of arrhythmias if used concurrently.
- Nitrates: May reverse the pressor effects of epinephrine.
- Levothyroxine: May potentiate the effects of epinephrine.
- Oxytocic agents: Hypertension may result if used concurrently.
- Other Sympathomimetic agents (isoproterenol): Should not be administered together as increased toxicity may result.
Frequently asked questions
What is Epinephrine used for in pets?
Epinephrine is a life-saving emergency medication used for severe allergic reactions (anaphylaxis). * **Emergency Use Only:** If you have been prescribed pre-loaded syringes (like an EpiPen) for your pet, use it *only* for known, severe allergic reactions as directed by your veterinarian. * **Seek Immediate Care:** Even after administering epinephrine, you must take your pet to a veterinary emergency clinic immediately. The drug wears off quickly, and the allergic reaction may return. * **Administration:** Ensure you understand the proper injection technique (usually into the muscle or under the skin) demonstrated by your vet. * **Storage:** Store at room temperature away from light. **Do not use** the medication if it is past its expiration date, if the liquid has turned pink or brown, or if you see particles floating in it.
Is Epinephrine safe for my pet?
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
This article is for general education and is not a substitute for professional veterinary advice. If your pet is unwell, please consult a veterinarian.
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