adrenaline at a glance
Medicine class
Sympathomimetic catecholamine and non-selective adrenergic agonist.
Main role
Emergency treatment of severe allergic reactions called anaphylaxis.
Administration
Available in the selected products as an injection into the outer thigh or a single-use nasal spray.
After use
Call 999 and say “anaphylaxis”, even if symptoms improve.
Preparedness
Carry two in-date prescribed devices and ensure carers and close contacts know how to use the particular product.
What is adrenaline used for?
The selected products are licensed for emergency treatment of anaphylaxis.
Anaphylaxis triggered by foods, medicines, insect stings or bites, or other allergens.
Anaphylaxis without an identified cause.
Exercise-induced anaphylaxis.
The selected nasal spray is licensed for adults and children weighing at least 30 kg.
How does adrenaline work?
Adrenaline activates alpha receptors, narrowing blood vessels and reducing leakage that contributes to swelling and low blood pressure. Beta-receptor activation relaxes airway muscle and supports the heart, helping to relieve wheezing, breathing difficulty and circulatory collapse. It may also reduce hives, itching and angioedema.
adrenaline preparations and strengths
Nasal preparation
Route: Nasal
Strengths: 2 mg
How to take adrenaline
Follow the instructions for the particular prescribed device and practise beforehand with an appropriate trainer where available.
Use adrenaline promptly when anaphylaxis is suspected; do not delay while waiting for symptoms to worsen.
For EpiPen, inject into the outer thigh. It may be used through clothing; keep fingers away from the orange end and do not inject into the buttock, hand or foot.
For EURneffy, do not prime or test-spray it. Insert the nozzle straight into a nostril before pressing the plunger; do not spray into the eyes or mouth.
The nasal spray may still be used with nasal congestion caused by a cold or allergy.
After administration, call 999, adopt the recommended lying position and remain with another person if possible.
Discard and replace a used or misfired single-use device. Check expiry dates and, for EpiPen, periodically check that the solution remains clear and colourless.
adrenaline side effects
Common or expected effects
- The nasal spray commonly causes headache, nasal discomfort, throat irritation, jitteriness, runny or congested nose, anxiety, tremor or palpitations.
- Adrenaline products can cause a fast heartbeat, raised blood pressure, sweating, pallor, dizziness, nausea, vomiting, weakness or nervousness; frequency is not established for several EpiPen effects.
Get urgent medical advice
- Chest pain, collapse, a markedly fast or irregular heartbeat, or severe breathing difficulty require urgent assessment; emergency assessment is required after every use regardless.
- Accidental injection into a hand or foot may reduce local blood flow, causing pallor, coldness or numbness; attend an emergency department immediately.
- Severe or worsening pain, swelling or redness at an injection site may indicate a rare serious infection and needs urgent medical assessment.
adrenaline in pregnancy
Pregnancy is not an absolute contraindication during anaphylaxis. Product information supports use when clinically necessary, although adrenaline can increase maternal blood pressure and heart rate, so emergency and obstetric assessment is important. After use, call 999 and lie on the left side while awaiting help.
adrenaline while breastfeeding
Adrenaline can be used when needed during breastfeeding. Infant exposure is expected to be very low because adrenaline has a short half-life and poor oral availability, but the prescriber should confirm that the supplied device remains appropriate.
adrenaline interactions
Interaction concerns should not delay emergency adrenaline for suspected anaphylaxis. Ensure the prescriber and emergency team know about all current medicines.
Beta-blockers, such as propranolol
May reduce adrenaline’s bronchodilating and cardiac effects.
Tricyclic antidepressants, MAO inhibitors and COMT inhibitors
May increase or prolong adrenaline’s cardiovascular effects.
Common questions about adrenaline
Answers are fully visible for fast scanning and source review.
Is adrenaline the same as epinephrine?
Yes. Epinephrine is another name for adrenaline and both names refer to the same active ingredient.
When should adrenaline be used for suspected anaphylaxis?
Use the prescribed device without delay when anaphylaxis is suspected, including airway swelling, breathing difficulty or signs of poor circulation.
Do I need to call 999 after using adrenaline?
Yes. Call 999 immediately and say “anaphylaxis”, even if symptoms appear to improve.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.