← Search & browse all drugs
RESPIRATORY SYSTEM › NASAL PREPARATIONS › DECONGESTANTS AND OTHER NASAL PREPARATIONS FOR TOPICAL USE › Sympathomimetics, plain
epinephrine
R01AA14
Forms & Strengths
- Nasal solution: 0.1% (1 mg/mL)
- Nasal spray: 0.05% (0.5 mg/mL)
Adult Dosing
- Nasal decongestant: 1-2 drops or sprays in each nostril every 4-6 hours as needed
- Limit use to 3-5 consecutive days to prevent rhinitis medicamentosa
Pediatric Dosing
- Children > 12 years: 1-2 sprays in each nostril every 4-6 hours as needed
- Children < 12 years: Safety and efficacy not established for OTC nasal use
Indications
- Temporary relief of nasal congestion associated with acute rhinitis, sinusitis, and common cold
Mechanism of Action
- Direct alpha-adrenergic agonist causing vasoconstriction of arterioles in the nasal mucosa
- Reduces local blood flow, mucosal edema, and nasal airway resistance
Contraindications
- Hypersensitivity to epinephrine or sympathomimetic amines
- Concurrent use with monoamine oxidase inhibitors (MAOIs)
- Narrow-angle glaucoma
- History of rhinitis medicamentosa
Adverse Reactions
- Transient stinging or burning of the nasal mucosa
- Sneezing
- Dryness of the nasal mucosa
- Rebound nasal congestion (rhinitis medicamentosa) with prolonged use
- Systemic effects (rare at nasal doses): tachycardia, palpitations, hypertension, nervousness, headache
Drug Interactions
- Monoamine oxidase inhibitors (MAOIs): May precipitate severe hypertensive crisis
- Tricyclic antidepressants: May potentiate sympathomimetic pressor response
- Beta-blockers: May lead to severe hypertension and reflex bradycardia due to unopposed alpha-adrenergic activity
- General anesthetics (halogenated hydrocarbons): Increased risk of ventricular arrhythmias
Curated Content: Needs Vetting Before Put to Clinical Use