FDA approved Adrenalin (epinephrine) for Anaphylaxis and Septic Shock HypotensionFDA approved Adrenalin for severe allergic reactions and septic shock.

Epinephrine is a non-selective alpha and beta adrenergic agonist. It acts on both alpha and beta receptors to produce vasoconstriction, bronchodilation, and increased heart rate and contractility.

Adrenalin is indicated for emergency treatment of allergic reactions (Type I), including anaphylaxis, which may result from insect stings or bites, foods, drugs, sera, diagnostic testing substances and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis. It is also indicated to increase mean arterial blood pressure in adult patients with hypotension associated with septic shock.

For anaphylaxis: Adults and children 30 kg or more: 0.3 to 0.5 mg (0.3 to 0.5 mL) intramuscularly or subcutaneously into the anterolateral aspect of the thigh every 5 to 10 minutes as necessary. Children less than 30 kg: 0.01 mg/kg (0.01 mL/kg) up to 0.3 mg (0.3 mL) intramuscularly or subcutaneously every 5 to 10 minutes as necessary. For septic shock: Dilute 1 mg in 1000 mL of 5% dextrose solution to produce 1 mcg/mL. Infuse into a large vein at 0.05 to 2 mcg/kg/min, titrated to desired mean arterial pressure. Wean gradually.

Trial data not available in label.

No contraindications listed. Drug interactions include drugs that counter pressor effects (alpha blockers, vasodilators, diuretics, antihypertensives, ergot alkaloids), drugs that potentiate effects (sympathomimetics, beta blockers, tricyclic antidepressants, MAO inhibitors, COMT inhibitors, clonidine, doxapram, oxytocin, levothyroxine, quinidine, certain antihistamines), and drugs that increase arrhythmogenic potential (beta blockers, cyclopropane, halogenated anesthetics, antihistamines, thyroid hormones, diuretics, cardiac glycosides). Potassium-depleting drugs potentiate hypokalemic effects.

Adrenalin is a first-line treatment for anaphylaxis and a vasopressor option for septic shock hypotension. Its use in anaphylaxis is standard of care. In septic shock, it is one of several vasopressors available for hemodynamic support.