Epinephrine

What is this medication for?

• Cardiopulmonary arrest (CPCR), anaphylaxis, bronchoconstriction/anaphylactic breathing difficulty/airway tightening

How is it given?

Give exactly as your veterinarian prescribed — never change the dose or stop on your own unless your veterinarian has told you to.

• Never confuse 1:1,000 (1 mg/mL) with 1:10,000 (0.1 mg/mL) concentrations — this is a well-known, potentially fatal dosing error; the 1:10,000 dilution is generally used into a vein.

What if I miss a dose?

• Give it as soon as you remember — unless it is almost time for the next dose (then skip the missed one; never double up).
• Call your clinic if you miss more than one dose in a row.

Side effects — what should I watch for?

Effects listed as common in this handout

• Anxiety, tremor, excitability, vomiting (Common)
• Hypertension, arrhythmias (overdose) (Dose-related, more likely with organic heart disease)

Worth a phone call to your veterinarian

• Hyperuricemia, lactic acidosis (prolonged/overdose use) (Uncommon)

⚠️ Contact your veterinarian or an emergency clinic IMMEDIATELY if you notice

• Injection-site tissue death (repeated injections) (Uncommon)

Before starting (or refilling), tell your veterinarian if your pet:

• has or has had: Narrow-angle glaucoma, shock from non-anaphylactoid causes, concurrent halogenated hydrocarbon anesthesia, cardiac dilatation/coronary insufficiency

• is pregnant, nursing, or used for breeding
• is taking any other medications, supplements, or flea/tick products, including:
  • Alpha-2 agonists (dexmedetomidine, xylazine)
  • Beta-blockers (propranolol)
  • Halogenated hydrocarbon anesthetics
  • Digoxin
  • TCAs, certain antihistamines

Storage and handling

Do not use if solution is discolored/brown (oxidized) or contains precipitate. Stable pH 3–4; unstable above pH 5.5.

Good to know

• Never confuse 1:1,000 (1 mg/mL) with 1:10,000 (0.1 mg/mL) concentrations — this is a well-known, potentially fatal dosing error; the 1:10,000 dilution is generally used into a vein.
• Vasopressin has increasingly supplanted or been used alongside epinephrine in some CPCR protocols — familiarize with current combined protocols rather than epinephrine alone.
• Pre-loaded syringes can be dispensed to owners of animals with known severe allergies (e.g., insect sting anaphylaxis) for emergency at-home use — discuss proper technique and storage.