The Asthma Center

Synthetic Epinephrine Medications

Synthetic versions of epinephrine are considered among the most valuable medications for emergency treatment of severe, life-threatening asthmatic attacks. They may be injected or inhaled and work quickly, often reversing bronchospasm within minutes.

Epinephrine medications have many uses including:

  • Treatment of severe allergic reactions (including anaphylactic shock)
  • Prolongation of the effects of local anesthetics like those used for dental procedures
  • Stimulation of the heart

Examples of epinephrine medications include:

  • Most over-the-counter "asthma inhalers" (such as Primatene® Mist)
  • Epinephrine injections administered in emergency rooms, hospitals and doctors' offices for acute asthmatic attacks
  • Self administered epinephrine injections (EpiPen®) for treatment of acute outpatient allergic reactions due to bee stings, food allergens, drug reactions and/or severe asthmatic attacks

Use

Since these medications work so quickly, they are often injected. While epinephrine medications are available in inhaler form in non-prescription preparations (Primatene® Mist), The Asthma Center specialists do not recommend these inhalers.

Risks and Precautions

Although epinephrine is a good bronchodilator with rapid onset of action, significant side effects may occur. Epinephrine medications may cause tremor, palpitations, irritability, restlessness and possibly nausea. These preparations should be used with caution in the elderly. You should also be cautious if you have hyperthyroidism, heart disease and/or high blood pressure. These medications absolutely should be avoided if you are receiving monoamine oxidase inhibitors (MAOs) in psychiatric treatment.The Asthma Center specialists do not recommend over-the-counter epinephrine inhalers because they are short acting and are more likely to cause heart stimulation. Overuse of those medications is very dangerous.

Frequent use of over-the-counter epinephrine inhalers (e.g. Primatene® Mist) or prescribed epinephrine-like inhalers (e.g. albuterol, Ventolin®, Proventil®) or need for frequent epinephrine injections is usually a clear sign of poor asthma control.