epinephrine inhaled (OTC)

Brand and Other Names:Primatene Mist
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

suspension for aerosol inhalation

  • 0.125mg/actuation

Mild Asthma

Indicated for temporary relief of mild symptoms of intermittent asthma (eg, wheezing, chest tightness, dyspnea)

1-2 inhalations PO q4hr PRN; start with 1 inhalation, wait at least 1 minute, administer second inhalation if symptoms not relieved

Not to exceed 8 inhalations/24 hr

Dosage Forms & Strengths

suspension for aerosol inhalation

  • 0.125mg/actuation

Mild Asthma

Indicated for temporary relief of mild symptoms of intermittent asthma (eg, wheezing, chest tightness, dyspnea)

<12 years: Safety and efficacy not established

≥12 years

  • 1-2 inhalations PO q4hr PRN; start with 1 inhalation, wait at least 1 minute, administer second inhalation if symptoms not relieved
  • Not to exceed 8 inhalations/24 hr
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Interactions

Interaction Checker

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            Adverse Effects

            Frequency Not Defined

            Tachycardia

            Increased blood pressure

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            Warnings

            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
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            Pregnancy & Lactation

            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.

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            Pharmacology

            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

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            Administration

            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

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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.