Intramuscular injections of Adrenaline into the buttocks should be avoided because of the risk of tissue necrosis. Tissue necrosis may also occur in the extremities, kidneys and liver. Repeated injections of Adrenaline can cause necrosis as a result of vascular constriction at the injection site. Monitor the patient as soon as possible (pulse, blood pressure, ECG, pulse oximetry) in order to assess the response to adrenaline.

The IV route for injection of epinephrine must be used with extreme caution and is best reserved for specialists familiar with IV use of epinephrine (adrenaline) in an appropriate setting. If the epinephrine 1:10,000 (0.1 mg/ml) injection is not available, epinephrine injection 1:1000 must be diluted to 1:10,000 before IV use. Adrenaline (Epinephrine) Injection BP 1:1000 (1mg/ml) is not suitable for IV use. The IM route is generally preferred in the initial treatment of anaphylaxis, the IV route is generally more appropriate in the Intensive Care Unit (ICU) or Emergency Department (ED) setting. Anginal pain may be induced when coronary insufficiency is present.Īdrenaline should be used with caution in older patientsĪdrenaline should be used with extreme caution in patients with long-standing bronchial asthma and emphysema who have developed degenerative heart disease.Īdrenaline should be used cautiously, if at all, during general anaesthesia with halogenated hydrocarbon anaesthetics (See section 4.5).Īdrenaline should not be used during the second stage of labour (See Section 4.6).Īccidental intravascular injection may result in cerebral haemorrhage due to the sudden rise in blood pressure.Īdrenaline (Epinephrine) Injection BP 1:1000 (1mg/ml) is not suitable for IV use.

organic heart disease or cardiac dilatation (severe angina pectoris, obstructive cardiomyopathy, hypertension) as well as most patients with arrhythmias.

autonomic dysreflexia (hyperreflexia), particularly in spinal cord injury (e.g.cerebrovascular disease, organic brain damage or arteriosclerosis.severe renal impairment, prostatic hypertrophy or urination difficulty.hyperthyroidism, psychoneurosis, phaeochromocytoma, narrow angle glaucoma, diabetes mellitus, hypokalaemia or hypercalcaemia.Adrenaline should be used with caution in patients with:

Adrenaline and high blood pressure