epinephrine inhaled (OTC)

Frequency Not Defined

Tachycardia

Increased blood pressure

Contraindications

Undiagnosed pulmonary symptoms

Coadministration with MAOIs, or within 2 weeks after discontinuing an MAOI

Cautions

Patients who have severe asthma or who have been hospitalized for asthma should seek medical attention for prescription medications to treat their asthma

Caution with preexisting conditions, including heart disease (eg, arrhythmias, coronary insufficiency, elevated blood pressure [BP]), diabetes, urinary impairment, enlarged prostate, thyroid disease, seizures, or narrow-angle glaucoma

May increase heart rate (HR) or BP

Not for relief of COPD symptoms

Drug interaction overview

• Coadministration with MAOIs or within 2 weeks after discontinuing an MAOI is contraindicated, owing to risk for hypertensive episode
• Tricyclic antidepressants may potentiate epinephrine effect on cardiovascular system
• Other stimulants (eg, phenylephrine, pseudoephedrine, ephedrine, caffeine) may have additive effects on HR or BP
• Caution with beta-blockers; may block bronchodilatory effects of epinephrine

Pregnancy

Control of asthma during pregnancy is essential for maternal and fetal health

In women with poorly or moderately controlled asthma, there is increased risk of preeclampsia in mother and prematurity, low birth weight, and small for gestational age in neonate; pregnant women should be closely monitored and medication adjusted as necessary to maintain optimal control

Beta-agonists may interfere with uterine contractility during labor

Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs

Lactation

Unknown if inhaled epinephrine is distributed in human milk

Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Mechanism of Action

Elicits beta1- and beta2-adrenergic effects, resulting in bronchial smooth muscle relaxation

Also has alpha-adrenergic effects that may increase HR and BP

Inhaled Administration

For oral inhalation only

Before first use only: Shake inhaler and spray into air; repeat both actions 4 times to assure inhaler is activated

Before subsequent doses (ie, 1-2 inhalations): Shake inhaler then spray into air once to prime

After each day of use: Wash by removing red cap and container; run water through mouthpiece for 30 seconds, then shake off excess water and let dry

Storage

Store at room temperature between 15-25°C (59-77°F)

Do not store near open flame