Patient leaflet - ADRENALINE (EPINEPHRINE) INJECTION BP 1:1000 FOR ANAPHYLAXIS
1. what adrenaline injection is and what it is used for
Adrenaline (Epinephrine) belongs to a group of medicines used for the treatment of serious shock produced by a severe allergic (hypersensitive) reaction or collapse.
2. what you need to know before you use adrenaline injection
You should not be given Adrenaline Injection if you:
- are allergic to adrenaline or any of the other ingredients of this medicine listed in section 6.
- have severe heart disease particularly if it is associated with an increased heart rate.
- are suffering from any infection, disease or tumour of the brain
- have atherosclerosis which is a narrowing, and hardening of the body’s blood vessels (your doctor will advise you).
- are in shock (other than that caused by a sudden life threatening reaction).
- are suffering from glaucoma (increased pressure in the eye).
- are having or are about to have an operation under general anaesthetic.
- are in labour.
Adrenaline injection should not be used in areas such as fingers, toes, ears, nose or penis, as the blood supply to these areas might become inadequate.
Warnings and precautions
Talk to your doctor or pharmacist before being given Adrenaline Injection if
- you are elderly
- you suffer from any heart problem, particularly if it affects the heart rate or if you suffer from chest pain
- you have problems with your brain e.g. stroke, brain damage or blood vessel disease
- you have an overactive thyroid, diabetes or glaucoma (high pressure in the eye)
- you have phaeochromocytoma (a tumour on the adrenal gland)
- you have low blood levels of potassium or high blood levels of calcium
- you have a tumour on your prostate gland or kidney disease
- you are in shock or have lost a lot of blood
- you are going to have a surgery under general anaesthesia
- you are suffering from high blood pressure
Other medicines and Adrenaline Injection
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Medicines that may interact with Adrenaline Injection include:
- monoamine oxidase inhibitors (MAOI) or tricyclic antidepressants both used for depression such as imipramine
- guanethidine, used for the rapid control of blood pressure
- diuretics (“water tablets”)
- inhaled general anaesthetics, such as halothane
- medicines to raise or lower your blood pressure including betablockers, e.g. propranolol, atenolol, bisoprolol, phentolamine
- anti-diabetic drugs like insulin or oral hypoglycaemic agents (e.g. glipizide)
- aminophylline and theophylline (medicines to help you breathe)
- corticosteroids (medicines used to treat inflammatory conditions in your body such as asthma or arthritis)
- antihistamines (for example: diphenhydramine), used for the treatment of allergies
- medicines used to treat mental illness like chlorpromazine, pericyazine or fluphenazine
- medicines used to treat an underactive thyroid gland
- oxytocin (used to induce labour at term and to control bleeding after delivery)
- any cough or cold remedies (sympathomimetics).
- ergot alkaloids(drugs used to treat migraine)
Pregnancy, breast-feeding and fertility
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before using this medicine. Adrenaline Injection should only be used during pregnancy and breast-feeding if considered essential by your doctor.
Driving and using machines
You should not drive or use machinery if you are affected by the administration of Adrenaline Injection.
Important information about some of the ingredients in this medication.
The product also contains Sodium Metabisulphite which may cause allergic (hypersensitive) type reactions in some people, which can lead to breathing difficulties or collapse. People with a history of asthma or allergies are most likely to experience these problems.
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3. How Adrenaline Injection is given
Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist or nurse if you not sure.
Your doctor, nurse or paramedic will administer adrenaline into a muscle (intramuscular).
In emergencies it may be necessary to administer an adrenaline solution slowly into a vein (intravenous). Your doctor will decide the correct dosage for you and when and how the injection should be administered.
Dosage:
Adults: 500 micrograms (0.5 ml) of 1:1000 adrenaline solution given by injection into the muscle (intramuscular)
Children: Volume of 1:1000 adrenaline to administer is shown in brackets.
| Age | Dose |
| Over 12 years | 0.5 mg IM (0.5ml 1:1000 solution) |
| 6 – 12 years | 0.3 mg IM (0.3ml 1:1000 solution) |
| 6 months – 6 years | 0.15 mg IM (0.15ml 1:1000 solution) |
| Under 6 months | 0.01mg/kg IM (0.01ml/kg 1:1000 solution) |
Repeat the intramuscular dose if there is no improvement in the patients condition. Further doses can be given at 5 minute intervals according to the patient’s response.
If you are given more Adrenaline Injection than you should
As this medicine will be given to you whilst you are in hospital, it is unlikely that you will be given too little or too much, however, tell your doctor or nurse if you have any concerns.
4. possible side effects
Like all medicines Adrenaline Injection can cause side effects, although not everybody gets them.
If you experience any of these following side effects, stop taking this medicine and report to a doctor immediately:
- allergic reactions although serious allergic reactions are rare
- any sudden wheeziness, difficulty in breathing, swelling of the eyelids, face or lips, rash or itching (especially affecting your whole body).
Other side effects (Not known: frequency cannot be estimated from the available data):
- headache
- dizziness
- feelings of anxiety or fear or restlessness
- trembling
- insomnia, confusion, irritability
- abnormal mood or behaviour
- a dry mouth or producing too much saliva
- weakness or sweating
- changes in the rhythm and speed of the heart
- high blood pressure
- coldness of the arms or legs
- breathlessness
- reduced appetite, feeling sick or being sick
- repeated injections may damage tissues at the site of the injection
- difficulty of not being able to pass water
- metabolic acidosis (an imbalance of certain constituents in your blood) may occur
- there may be some tissue damage at the site of injection after repeated injections of adrenaline
- increase in tremors and rigidity in patients suffering from a condition called Parkinsonian syndrome
- bleeding in the head
- paralysis of one half of the body
- increased sugar levels in the blood
- breakdown of fat in the body.
5. how to store adrenaline injection
Keep this medicine of the sight and reach of children.
Your doctor, nurse or paramedic will check that the expiry date on the label has not been passed before administering Adrenaline Injection to you. The expiry date refers to the last day of the month.
Adrenaline (Epinephrine) is sensitive to light; therefore the Adrenaline Injection must always be kept in the original outer carton.
Do not store above 25°C and do not freeze.
You should not be given Adrenaline Injection if you notice it has been used or shows signs of visible damage.
6. contents of the pack and other information
What Adrenaline Injection contains
The active ingredient is Adrenaline (Epinephrine) (as acid tartrate).
Each 1ml solution for injection contains 1mg of adrenaline (epinephrine) as the acid tartrate.
The other ingredients are Sodium Chloride, Sodium Metabisulphite and Water for Injections. Dilute Hydrochloric acid may be added to adjust the acidity.
What Adrenaline Injection looks like and contents of the pack
Adrenaline Injection is a clear, colourless solution supplied in a prefilled syringe with a needle.Marketing Authorisation Holder:
Aurum Pharmaceuticals Ltd.
Bampton Road, Romford, RM3 8UG, United Kingdom
Manufacturer:
Martindale Pharmaceuticals Ltd.
Bampton Road, Romford, RM3 8UG, United Kingdom
This leaflet was last approved in: November 2017
Product License Number: PL 12064/0058
© Bampton Road, Harold Hill, Romford RM3 8UG, United Kingdom
Aurum
Continued overleaf
100mm Measurement Verification Bar
3915-B