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