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