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