Indications and Usage
Epinephrine Injection, USP is indicated for intravenous injection in (1) treatment of acute hypersensitivity (anaphylactoid reactions to drugs, animal serums and other allergens), (2) treatment of acute asthmatic attacks to relieve bronchospasm not controlled by inhalation or subcutaneous administration of other solutions of the drug and (3) treatment and prophylaxis of cardiac arrest and attacks of transitory atrioventricular (A-V) heart block with syncopal seizures (Stokes-Adams Syndrome). In acute attacks of ventricular standstill, physical measures should be applied first. When external cardiac compression and attempts to restore the circulation by electrical defibrillation or use of a pacemaker fail, intracardiac puncture and intramyocardial injection of epinephrine may be effective.
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Dosage and Administration
Epinephrine Injection, USP is administered by intravenous injection and/or in cardiac arrest, by intracardiac injection into the left ventricular chamber or via endotracheal tube directly into the bronchial tree. The adult intravenous dose for hypersensitivity reactions or to relieve bronchospasm usually ranges from 0.1 to 0.25 mg (1 to 2.5 mL of 1:10,000 solution), injected slowly. Neonates may be given a dose of 0.01 mg per kg of body weight; for the infant 0.05 mg is an adequate initial dose and this may be repeated at 20 to 30 minute intervals in the management of asthma attacks. In cardiac arrest, 0.5 to 1.0 mg (5 to 10 mL of 1:10,000 solution) may be given. During a resuscitation effort, 0.5 mg (5 mL) should be administered intravenously every five minutes. Intracardiac injection should only be administered by personnel well trained in the technique, if there has not been sufficient time to establish an intravenous route. The intracardiac dose usually ranges from 0.3 to 0.5 mg (3 to 5 mL of 1:10,000 solution). Alternatively, if the patient has been intubated, epinephrine can be injected via the endotracheal tube directly into the bronchial tree at the same dosage as for intravenous injection. It is rapidly absorbed through the lung capillary bed. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. (See PRECAUTIONS.) To prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand.
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How Supplied
Epinephrine Injection, USP is supplied in single-dose containers as follows:
List No.
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Container Type
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Size
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Concentration
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Total Content (Epinephrine)
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4901
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Abboject Syringe* 18-G 3 1/2 inch (intracardiac)
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10 mL
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0.1 mg/mL
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1 mg
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4921
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Abboject Syringe* 21-G 1 1.2 inch
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10 mL
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0.1 mg/mL
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1 mg
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4921
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Abboject Lifeshield Syringe** 20-G
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10 mL
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0.1 mg/mL
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1 mg
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4921
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Abboject Lifeshield Syringe*** 20-G
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10 mL
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0.1 mg/mL
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1 mg
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4320
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Fliptop Vial
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10 mL
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0.1 mg/mL
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1 mg
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* Abboject® Unit of Use Syringe ** Abboject® LifeShield® Unit of Use Syringe with protected needle *** Abboject® LifeShield® Unit of Use Syringe with protected needle and male luer lock adapter.
Store at 20 to 25ºC (68 to 77ºF). [See USP Controlled Room Temperature.]
Protect from light.
TO PREVENT NEEDLE-STICK INJURIES, NEEDLES SHOULD NOT BE RECAPPED, PURPOSELY BENT OR BROKEN BY HAND.
Revised: October, 2004
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