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