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	Epinephrin (R)-(-)-Adnephrine 4-((1R)-1-HYDROXY-2-(METHYLAMINO)ETHYL)-1,2-BENZENEDIOL (R)-(−)-adrenaline Epinephrine acetate Epinefrina (R)-(-)-Epinephrine 1,2-BENZENEDIOL, 4-(1-HYDROXY-2-(METHYLAMINO)ETHYL)-, (R)- L-Adrenaline Epinephrine Epinephrine hydrochloride Epinephrinum RACEPINEFRINE, (R)- 4-[(1R)-1-Hydroxy-2-(methylamino)ethyl]-1,2-benzenediol (R)-(-)-Adrenaline BENZYL ALCOHOL, 3,4-DIHYDROXY-.ALPHA.-((METHYLAMINO)METHYL)-, (-)- (−)-3,4-dihydroxy-α-((methylamino)methyl)benzyl alcohol Adrénaline (−)-adrenaline Adrenaline Levoepinephrine (R)-(-)-Epirenamine Epinefrin (−)-(R)-epinephrine Epinephrine bitartrate
Brand Names	The Solution Gingi-pak Max Z-twist No 00 Numbing Hemorrhoidal Label Adrenalin Vials Ana-kit EPIsnap Epinephrine Convenience Kit Adyphren II Kit Auvi-Q Epinephrine Inj 0.1mg/ml USP Marcaine with Epinephrine Blue Gel Anesthetic Lidocaine Hydrochloride and Epinephrine Injection USP Sensorcaine(r) (bupivacaine Hci and Epinephrine) Octocaine 100 Needleject Inj 4% Citanest Forte Dental With Epinephrine 1:200,000 D-Care 100X Epinephrine Injection USP Epinephrine Primatene Mist Ephinephrine Lidocaine Hydrochloride 0.5% and Epinephrine 1:200000 Injection USP Lidocaine Hydrochloride 1.5% and Epinephrine 1:200000 Injection USP Test Dose Adrenaclick 0.15mg Auto-injector 4% Astracaine Dental With Epinephrine Forte 1:100,000 (0.01mg/ml) Vasocaine The Solution Anorectal Spray Temporary Pain Relief Zone 2 Septocaine Pro Numb Sensitive Skin Gingi-pak Max Soft-twist No 1 Xylocaine(r) -mpf (lidocaine Hci and Epinephrine) Leep RediKit Taro-epinephrine Auto-injector E-pilo-1 Oph Soln Articaine Posicaine N Lidosite Epinephrine Professional EMS EpinephrineSnap-EMS Adrenalin (epinephrine in sodium chloride) Numquick Topical Analgesic Certa Dose Epinephrine Convenience Kit Numquick Analgesic E-pilo 2 Ophthalmic Solution Zorcaine Octocaine HCl 2% Epinephrine 1:100000 EPY II Kit Septanest Sp Gingi-pak Max Soft-twist No 2 Orostat 8% Lidocaine Hci and Epinephrine Lidocaine 2% and Epinephrine 1:100 000 E-pilo 1 Ophthalmic Solution Ultracaine DS Forte Inj Xylocaine 0.5% W Epinephrine 1:100000 Twinject 0.3mg Auto-injector Xylocaine 1% W Epinephrine 1:200000 Marcaine 0.5% and Epinephrine 1:200,000 Liq Marcaine With Epinephrine Octocaine HCl 2% Epinephrine 1:50000 Orabloc Xylocaine 2% With Epinephrine 1:200000 Adrenalin Emerade LIDOCAINE HCl AND EPI Primatene Mist Refill Dysne Inhal Adrenaclick Medihaler-Epi Lidocaine Flavalta Bupivacaine Hci and Epinephrine LIDOCAINE HCl and EPINEPHRINE Gingi-pak Max Z-twist No 1 EPY Kit Anapen Junior Epi E-Z Pen - Liquid - 0.3mg/0.3ml Deluxe Dental Emergency Kit Ultracaine D-S Injection Dentsply 2% Lidocaine With Epinephrine 1:50,000 Orabloc 1:200,000 Lignospan Forte Gingi-pak Max 2-ply Articadent Septocaine and Epinephrine 2% Lidocaine and Epinephrine 1:100,000 Injection USP Gold Label Anorectal Numbing Spray Bupivacaine Hydrochloride and Epinephrine Epinephrine Pediatrics Epinephrine Injection Dentsply 2% Lidocaine With Epinephrine 1:100,000 Xylocaine Dental Lidocaine HCl 2% and Epinephrine 1:100,000 Posicaine Sp Lidocaine 2% and Epinephrine 1:50 000 Marcaine E Liq Prt 0.50% Gingi-pak Max Soft-twist No 3 Lidocaine Hci and Epinephrine With Epinephrine LIDOCAINE HCl Spinal Anaesthesia Tray Adyphren Amp II Kit Bupivacaine Hydrochloride with Epinephrine Ultacan Forte Xylocaine 2% W Epinephrine 1:100000 Neffy Marcaine Xylocaine MPF Dentsply 4% Prilocaine and Epinephrine Injection 1:200,000 Articaine Hydrochloride and Epinephrine Xylocaine Sensorcaine Forte Taroclick Epinephrine Junior E-pilo 4 Ophthalmic Solution Lixtraxen 1% Ultracaine D-S Forte Injection Sensorcaine EpinephrineSnap-V LIDOCAINE HCl AND EPINEPHRINE Adyphren Kit Spinal Anesthesia Tray Lidocaine Hydrochloride 1.5% and Epinephrine 1:200000 Injection USP Bronkaid Mistometer Aem 0.5% Xylocaine with epinephrine Epipen Jr Crown-pak Max 4-ply Twinject 0.15mg Auto-injector Twinject Pro Numb Octocaine 50 Octocaine 100 Lidocaine Hydrochloride and Epinephrine Ultacan Epinephrine Chloride Solution Articaine Hydrochloride and Epinephrine Bitartrate Injection Orabloc 1:100,000 Epinephrine 0.15 Pediatrics E-pilo-4 Oph Soln Taroclick Epinephrine CLIN-LIDO-Single Use Kit Gingi-pak Pellets Xylocaine 2% W Epinephrine 1:200000 Epinephrinesnap-V SENSORCAINE MPF with Epinephrine Lidocaine Hydrochloride and Epinephrine Bitartrate Epinephrine 0.3 Adults Bupivacaine HCl 0.5% and Epinephrine 1:200,000 Injection Eurneffy Basic Dental Emergency Kit Ultracaine DS Inj E-pilo 6 Ophthalmic Solution Citanest Forte DENTAL Septanest N Xylocaine-mpf With Epi Xylocaine 1.5% W Epinephrine 1:200000 Adyphren Amp Kit Anapen Marcaine E 0.25% Liq Prt Prilocaine HCl 4% Epineph 1:200000inj Citanest Forte Marcaine E Ana-kit (2mg/tab Orl, 1mg/ml Liq Sc Im) Adrenalin (epinephrine) Lignospan Speciale Inj Gingi-pak Max Z-twist No 3 Sensorcaine With Epinephrine EpiPen Adrenalin(r) Epipen Epinephrine 1:1000 Inj 1mg/ml USP Xylocaine Mpf 1.5% With Epinephrine Xylocaine 1% W Epinephrine 1:100000 Vivacaine Adrenaclick 0.30mg Auto-injector Epinephrine Injection USP 1 mg/ml Articaine HCl and Epinephrine EpiPen Jr Gingi Pak Cord No 1 4% Astracaine Dental With Epinephrine 1:200,000 (0.005mg/ml) Xylocaine 0.5% W Epinephrine 1:200000 Epinephrine Professional Lidocaine and Epinephrine Inj.usp 2% 1:100000 Lignospan Standard Sensorcaine Mpf Minnerva II Prime Asthma Relief Prilocaine Hydrochloride with Epinephrine QKit Procedure Tray Lidocaine 2% and Epinephrine 1:100,000 E-pilo-6 Oph Soln Scandonest 2% Special Inj Anakit Insect Sting Treatment Kit E-pilo-2 Oph Soln Lidocaine 2% and Epinephrine 1:50,000 Adrenalin Topical Solution Symjepi Xylocaine Dental Lidocaine Hydrochloride 2% and Epinephrine 1:50,000 Lidocaine Hci Xylocaine 1.5% W Epinephrine 1:200000 Test Dose Gingi-pak Cotton Coil Gingi-pak Max Z-twist No 2 Epinephrine Convenience Kit Allerject
Indication	Epinephrine injection and nasal spray are indicated in the emergency treatment of type I allergic reactions, including anaphylaxis.[L41260, L51798, L56117] 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