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epinephrine

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Brand names: EpiPen, Adrenalin

Adrenergic Agonist Rx

Epinephrine injection is a medicine that raises blood pressure. It is used for adults with very low blood pressure due to septic shock.

Drug Shortage Alert

epinephrine is currently listed as in shortage by the FDA. Affected manufacturer: Fresenius Kabi USA, LLC. Status: Available.

View all drug shortages →

Drug Pricing (NADAC)

Brand Price

$14.23/unit

Generic Price

$100.76/unit

Generic Available

Yes (9 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Epinephrine injection is used to increase blood pressure in adults.

Common side effects

Headache, Anxiety, Feeling restless

Key warnings

Your blood pressure will be checked often while you are taking this medicine.

How It Works

Epinephrine works on alpha and beta receptors in your body. This causes your blood vessels to narrow and your heart to beat stronger and faster. As a result, your blood pressure increases.

How to Take It

Epinephrine will be given to you in a hospital. It is given through a vein after being mixed with a dextrose solution. The dose is based on your weight and blood pressure, starting at 0.05 mcg/kg/min and can go up to 2 mcg/kg/min. The doctor will slowly lower the dose when your blood pressure is stable.

Pregnancy & Breastfeeding

Epinephrine may harm your unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. Epinephrine can also slow down labor.

Missed Dose

This medicine is given in a hospital, so you will not miss a dose.

Storage

Store at room temperature (68° to 77°F) and protect from light and freezing.

Side Effects (from patient reports)

Based on 35,201 FDA adverse event reports.

The medicine did not work
5,555
Headache
4,161
Sinus infection
3,917
Tiredness
3,761
Difficulty breathing
3,216
Pain
3,152
Feeling sick to your stomach
3,135
A dose of the medicine was missed
2,999
Using the medicine for a purpose it was not approved for
2,729
COVID-19
2,576

FDA Adverse Event Report Analysis

Detailed analysis of 61,536 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 1999–2025.

Total Reports

61,536

Death-Related Reports

3,931

Hospitalization Reports

16,914

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 35,449 (66%)
Male 17,773 (33%)

Age Distribution

0–17 5,168
18–44 8,913
45–64 11,022
65–74 4,915
75+ 2,625

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DRUG INEFFECTIVE 5,555
2 HEADACHE 4,161
3 SINUSITIS 3,917
4 FATIGUE 3,761
5 DYSPNOEA 3,215
6 PAIN 3,151
7 NAUSEA 3,135
8 PRODUCT DOSE OMISSION ISSUE 2,999
9 OFF LABEL USE 2,729
10 COVID-19 2,576
11 PNEUMONIA 2,495
12 COUGH 2,114
13 PYREXIA 2,108
14 NASOPHARYNGITIS 2,089
15 RASH 2,018

Reactions in Death Reports

DEATH 1,225
DRUG INEFFECTIVE 923
CARDIAC ARREST 480
RENAL FAILURE 380
PAIN 361
HYPOTENSION 307
INJURY 289
PNEUMONIA 282
ANXIETY 271
UNEVALUABLE EVENT 252

Reactions in Hospitalization Reports

DRUG INEFFECTIVE 2,536
PNEUMONIA 1,611
DYSPNOEA 1,453
PRODUCT DOSE OMISSION ISSUE 1,359
FATIGUE 1,214
PAIN 1,172
HEADACHE 1,166
COVID-19 1,111
NAUSEA 1,053
SINUSITIS 1,051

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Your blood pressure will be checked often while you are taking this medicine. Epinephrine can raise your blood pressure too high. It can also cause fluid to build up in your lungs. Epinephrine may cause irregular heartbeats or reduce blood flow to the heart. Avoid leakage of the medicine into the tissues, as this can cause tissue damage. This medicine contains sulfite, which can cause allergic reactions.

Known Drug Interactions

If in the absence of therapeutic alternatives and emergency treatment with a contraindicated drug (e.g., linezolid, intravenous methylene blue, direct-acting sympathomimetic drugs such as epinephrine) becomes necessary and cannot be delayed, discontinue tranylcypromine tablets as soon as possible before initiating treatment with the other agent, and monitor closely for adverse reactions. Excessive reduction of blood glucose (additive effect) [See Warnings and Precautions (5.14)] ; CNS depressant agents (including opioids, alcohol, sedatives, hypnotics) Use with caution Increased CNS depress...

Mechanism: Tranylcypromine prevents the body from breaking down epinephrine, which can cause a sudden and dangerously high spike in blood pressure.

What to do: Avoid this combination unless it is a medical emergency. If used in an emergency, a doctor must monitor your blood pressure and heart rate very closely.

7.2 Drugs Metabolized by Catechol-O-Methyltransferase (COMT) Drugs known to be metabolized by COMT, such as isoproterenol, epinephrine, norepinephrine, dopamine, dobutamine, alpha-methyldopa, apomorphine, isoetherine, and bitolterol should be administered with caution in patients receiving entacapone regardless of the route of administration (including inhalation), as their interaction may result in increased heart rates, possibly arrhythmias, and excessive changes in blood pressure [ see Warnings and Precautions (5.10) ].

Mechanism: Epinephrine is broken down by an enzyme that is affected by this medication. This can lead to higher levels of epinephrine in the blood, causing a fast heart rate or high blood pressure.

What to do: Use caution when taking these drugs together. Your doctor should monitor your heart rate and blood pressure for any unusual changes.

moderate digoxin

Sympathomimetics Epinephrine Norepinephrine Dopamine Can increase the risk of cardiac arrhythmias Neuromuscular Blocking Agents Succinylcholine May cause sudden extrusion of potassium from muscle cells causing arrhythmias in patients taking digoxin.

Mechanism: Both drugs affect how the heart beats, and taking them together can cause the heart to develop dangerous, irregular rhythms.

What to do: Your doctor should monitor your heart rhythm closely if these drugs are used together.

moderate imipramine

Avoid the use of preparations, such as decongestants and local anesthetics, that contain any sympathomimetic amine (e.g., epinephrine, norepinephrine), since it has been reported that tricyclic antidepressants can potentiate the effects of catecholamines.

Mechanism: Imipramine can make the effects of epinephrine much stronger, which could cause a dangerous physical reaction.

What to do: Avoid using medicines or local numbing agents that contain epinephrine while you are taking imipramine.

( 7 .1) Drugs that potentiate the effects of epinephrine include sympathomimetics, beta blockers, tricyclic antidepressants, MAO inhibitors, COMT inhibitors, clonidine, doxapram, oxytocin, levothyroxine sodium, and certain antihistamines.

Mechanism: Levothyroxine can make your heart and blood vessels more sensitive to epinephrine. This can cause the epinephrine to have a much stronger effect on your body than intended.

What to do: Your healthcare provider should watch your heart rate and blood pressure carefully if you are using both of these drugs.

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Common Questions

What should I tell my doctor before taking epinephrine?
Tell your doctor if you have heart problems, high blood pressure, diabetes, or any allergies, especially to sulfites.
Can epinephrine cause any long-term effects?
Epinephrine is usually given for a short period of time. Long-term effects are not common, but your doctor will monitor you for any potential problems.
What if my blood pressure gets too high?
The medical staff will monitor your blood pressure closely and adjust the dose of epinephrine as needed.
Can epinephrine interact with other medications I'm taking?
Yes, epinephrine can interact with many medications. Tell your doctor about all the medicines you are taking, including over-the-counter drugs and supplements.
Will I feel any pain when epinephrine is injected?
You may feel some discomfort at the injection site. Tell the nurse if you have pain, burning, or stinging.
How long will I need to take epinephrine?
You will take epinephrine only until your blood pressure improves. Your doctor will decide when to stop the medicine.
What happens if the epinephrine leaks out of the vein?
Leakage of epinephrine into the tissues can cause damage. The medical staff will check the injection site often and treat any leakage promptly.
Can epinephrine cause any mental or emotional changes?
Epinephrine can cause anxiety, nervousness, and restlessness. Tell your doctor if you experience any of these changes.
Is it safe to breastfeed while taking epinephrine?
It is not known if epinephrine passes into breast milk. Talk to your doctor about the risks and benefits of breastfeeding.
What if I have an allergic reaction to epinephrine?
Stop taking the medicine and get medical help right away if you have signs of an allergic reaction, such as rash, itching, swelling, or trouble breathing.
What are the common side effects of epinephrine?
The most commonly reported side effects of epinephrine include Headache, Anxiety, Feeling restless, Shaking, Weakness. Based on 35,201 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does epinephrine interact with other medications?
Yes, epinephrine has 28 known drug interactions. Notable interactions include tranylcypromine, carbidopa/levodopa, digoxin. Always inform your doctor about all medications you are taking.
What drug class is epinephrine?
epinephrine belongs to the Adrenergic Agonist drug class. It requires a prescription (Rx). Epinephrine injection is used to increase blood pressure in adults.
Is epinephrine safe during pregnancy?
Epinephrine may harm your unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Has epinephrine been recalled?
There are 5 recalls associated with epinephrine products. CGMP Deviations: Insanitary conditions including rodent exposure/activity in their distribution center. Check the recalls section below for full details and affected products.
Is epinephrine currently in shortage?
Yes, epinephrine is currently listed as in shortage by the FDA. Affected manufacturer: Fresenius Kabi USA, LLC. Status: Available. Visit the FDA Drug Shortages database for the latest updates.

Active Recalls

Class II December 26, 2025

CGMP Deviations: Insanitary conditions including rodent exposure/activity in their distribution center.

GOLD STAR DISTRIBUTION INC

Class II June 2, 2025

Lack of Assurance of Sterility: A recent FDA inspection revealed concerns with the sterile manufacturing process.

Tailstorm Health INC

Class III April 10, 2024

Out of specification for assay

Imprimis NJOF, LLC

Class III March 16, 2023

Labeling; Incorrect NDC number on outer carton of product.

Focus Health Group Inc

Class I March 12, 2017

Defective Delivery System; reports of the device failing to activate which could result in a patient not receiving medication

Meridian Medical Technologies a Pfizer Company

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What the FDA Data Shows for epinephrine

The FDA label for epinephrine (sold under brand names such as EpiPen, Adrenalin) classifies it as a prescription-only medication in the Adrenergic Agonist class. Epinephrine injection is used to increase blood pressure in adults. Official labeling lists 13 commonly reported side effects, including Headache, Anxiety, Feeling restless.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 35,201 voluntary reports. The database also lists 28 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $100.76 versus $14.23 for the brand.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 5 recall records on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC). Shortage status: FDA Drug Shortages Database.

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: July 30, 2025

All federal data sources used on this page