Epinephrine

What is epinephrine?

Epinephrine (Epiclor:Rafter 8®, VetOne Epinephrine®) is an injectable drug used most often in emergency situations for animals (e.g., anaphylaxis, cardiopulmonary resuscitation [CPR]).

It may also be added to local anesthesia drugs because it causes the veins to constrict, thus delaying the body’s absorption of the drugs and prolonging the duration of the local anesthetic duration.

Human formulations of epinephrine are often used off-label. Many drugs are commonly prescribed for off-label use in veterinary medicine. "Off label" means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How is epinephrine given?

• Epinephrine comes as an injectable solution that is used for either injections into the muscle (IM) or under the skin (SQ).
• Follow your veterinarian’s directions and give this medication exactly as prescribed. 
• Epinephrine may be prescribed as pre-filled single-dose syringes or auto-injectors (Epi-pen®).
• There are no known major precautions for humans exposed to epinephrine, other than to avoid accidentally injecting it into your body. 

This medication should take effect immediately and improvement in clinical signs should follow.

What if I miss giving my pet the medication?

Epinephrine is reserved for use in emergency situations. If you do not have epinephrine available and your pet starts having an allergic reaction, contact your veterinarian or emergency animal services immediately. 

Are there any potential side effects?

Epinephrine may cause the following side effects:

• increased heart rate
• nervousness, restlessness, and excitement
• nausea and vomiting
• increased blood pressure
• tissue damage when injected repeatedly in the same area of tissue 

Are there any risk factors for this medication?

Epinephrine should NOT BE USED in pets: 

• that have a known hypersensitivity to or allergy to it

Epinephrine should be USED WITH CAUTION in pets:

• that are diabetic
• with high blood pressure
• with an abnormal heart rhythm
• with a low circulating blood volume
• that are giving birth
• that are pregnant or nursing

Are there any drug interactions I should be aware of?f

Certain medications may interact with epinephrine, so it is important to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is using before starting any new treatment. 

Several medications should be used with caution when given with epinephrine, including:

Is any monitoring needed with this medication?

Follow up with your veterinarian after giving epinephrine and follow their instructions for monitoring.

How do I store epinephrine?

• Store at controlled room temperature, between 15°C and 30°C (59°F and 86°F).
• Protect from light.
• Keep away from children and other animals.
• Do not use if the liquid is discolored or has evidence of material floating in it.

Ask your veterinarian for specific disposal instructions. Do not flush medicines down the sink or toilet unless instructed to do so.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet's weight and symptoms.