Adrenaline
Adrenaline is the first-line treatment for severe allergic reactions to food, insect stings, medication, latex, exercise and other allergens and is classified as an essential medication for the treatment of anaphylaxis.1
Adrenaline acts fast and rapidly treats the symptoms of anaphylaxis, including throat swelling and difficulty breathing.2,3 Symptoms that signal the onset of an anaphylactic reaction include: itching of the skin; raised rash (like a nettle rash); flushing; swelling of the lips, throat, tongue, hands and feet; wheezing; hoarseness; nausea; vomiting; abdominal cramps and in some cases, loss of consciousness.2,3 It works most effectively if it is given within the first few minutes of a severe allergic reaction.1
Smooth muscle contraction and increased vascular resistance
Smooth muscle contraction and inhibition of transmitter release
Increased cardiac contraction force and heart rate
Decreased inflammatory mediator release and increased bronchodilation
Adrenaline is a combined alpha- and beta-agonist causing peripheral vasoconstriction (reversing hypotension and mucosal oedema), increased rate and force of cardiac contractions (reversing hypotension), reversal of bronchoconstriction, and reduction in release of inflammatory mediators.4
Dosage and administration
Adrenaline auto injectors are prescribed for self administration and are intended for the emergency treatment of severe allergic reactions (anaphylaxis).2,3
EpiPen® and EpiPen Junior Auto-injectors are designed for intramuscular administration into the anterolateral thigh, not the buttock.2,3
The physician prescribing an EpiPen® / EpiPen® Junior Auto-Injector must ensure that the patient understands the indications for use and the correct method of administration. Therefore, the physician should discuss the patient information leaflet, the correct handling of the Auto-Injector and the possible symptoms of an anaphylactic shock in detail with the patient. It is recommended that patients are prescribed two EpiPen® / EpiPen® Junior Auto-Injectors which they should carry at all times.5,6
Side Effects
Side effects associated with adrenaline's alpha and beta receptor activity may include, but are not limited to, symptoms such as tachycardia and hypertension as well as undesirable effects on the central nervous system.5,6
Please refer to the EpiPen® and EpiPen® Junior Summary of Product Characteristics (SmPC) for a full list of possible side effects.
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.
Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system HPRA Pharmacovigilance, Website: www.hpra.ie
Adverse reactions/events should also be reported to the marketing authorisation holder at email address: pv.ireland@viatris.com or phone 0044 (0) 800 1218267
- Cardona, Victoria et al. World Allergy Organization Anaphylaxis Guidance 2020. World Allergy Organization Journal, Volume 13, Issue 10, 100472.
- EpiPen (adrenaline) 300 micrograms solution for injection in pre-filled pen, Patient Information Leaflet (PIL) Available at: www.medicines.ie. Last accessed: 24th October 2025.
- EpiPen Junior (adrenaline) 150 micrograms solution for injection in pre-filled pen, Patient Information Leaflet (PIL). Available at: www.medicines.ie. Last accessed: 24th October 2025.
- Muraro, A et al. 2014. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy, 69(8), pp. 1026-1045.
- EpiPen (adrenaline) 300 micrograms solution for injection in pre-filled pen, Summary of Product Characteristics. Available at: www.medicines.ie. Last accessed: 24th October 2025.
- EpiPen Junior (adrenaline) 150 micrograms solution for injection in pre-filled pen, Summary of Product Characteristics. Available at: www.medicines.ie. Last accessed: 24th October 2025.
Reporting of adverse reactions:
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.
Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system HPRA Pharmacovigilance, Website: www.hpra.ie
Adverse reactions/events should also be reported to the marketing authorisation holder at email address: pv.ireland@viatris.com or phone 0044 (0) 800 1218267.
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