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Adrenaline: Brands, Price & Uses in Bangladesh
Established / Emergency Indications Anaphylaxis: Adrenaline is the first-line emergency treatment for severe allergic reactions (anaphylaxis) of any cause, including insect stings, foods, drugs and more.
About Adrenaline
Indications of Adrenaline
Established / Emergency Indications
- Anaphylaxis: Adrenaline is the first-line emergency treatment for severe allergic reactions (anaphylaxis) of any cause, including insect stings, foods, drugs, latex, or idiopathic anaphylaxis.
- Cardiac arrest (ACLS): Adrenaline is used as part of Advanced Cardiovascular Life Support (ACLS) protocols for cardiac arrest, including asystole, pulseless electrical activity, and shock-refractory ventricular fibrillation/pulseless ventricular tachycardia.
- Severe acute asthma/bronchospasm: Adrenaline may be used for severe, life-threatening bronchospasm or acute asthma exacerbation that has failed to respond adequately to inhaled bronchodilator (e.g., salbutamol) therapy.
- Septic shock (adjunct): Adrenaline is used as an adjunct vasopressor to raise mean arterial blood pressure in adults with hypotension associated with septic shock that is inadequately responsive to first-line vasopressors and fluid resuscitation.
Combination / Adjunct Use
- Local anesthetic additive: Adrenaline is combined with local anesthetics (e.g., lidocaine) to prolong the duration of local/regional anesthesia and reduce surgical-site bleeding through local vasoconstriction.
- Croup: Nebulized racemic or L-Adrenaline is used in hospital settings for moderate-to-severe croup (laryngotracheobronchitis) to reduce airway edema.
Use of Adrenaline outside emergency settings (e.g., as a vasoconstrictor additive) should follow standard clinical protocols and physician guidance.
Dosage & Administration of Adrenaline
Anaphylaxis
| Population | Dose | Route |
|---|---|---|
| Adults and children ≥30 kg | 0.3-0.5 mg (0.3-0.5 mL of 1 mg/mL solution) | Intramuscular (preferred, anterolateral thigh), may repeat every 5-15 minutes as needed |
| Children <30 kg | 0.01 mg/kg (max single dose 0.3 mg), or per weight-banded auto-injector strength | Intramuscular, anterolateral thigh |
Cardiac Arrest (ACLS)
| Route | Dose |
|---|---|
| Intravenous/intraosseous | 1 mg every 3-5 minutes during resuscitation |
| Endotracheal (if IV/IO access unavailable) | 2-2.5 mg diluted, higher dose required due to reduced absorption |
Severe Acute Asthma/Bronchospasm
0.3-0.5 mg intramuscularly or subcutaneously, may be repeated every 20 minutes to 4 hours as needed, only when inhaled bronchodilators have failed and under medical supervision.
Septic Shock (Adjunct Vasopressor)
Given as a continuous intravenous infusion, typically starting at 0.05-0.1 mcg/kg/min, titrated to target blood pressure under continuous hemodynamic monitoring in a critical care setting.
As Additive to Local Anesthetics
Used at low concentrations (commonly 1:100,000 to 1:200,000) combined with local anesthetic solutions, administered by the treating clinician per standard local/regional anesthesia protocols.
Adrenaline for life-threatening anaphylaxis or cardiac arrest must be given immediately; do not delay administration to assess relative cautions in these emergencies. Auto-injector devices are designed for immediate use by patients, caregivers, or bystanders when anaphylaxis is suspected, followed by emergency medical care.
Side Effects of Adrenaline
Common, generally transient effects of Adrenaline used in emergencies include:
- Anxiety, restlessness, or a feeling of fear
- Tremor
- Palpitations and rapid heart rate
- Headache
- Sweating and pallor
- Dizziness
- Nausea or vomiting
Less common but more serious effects can include significant hypertension, cardiac arrhythmias (including ventricular arrhythmias), pulmonary edema, and, rarely, cerebral hemorrhage, particularly with excessive dosing or rapid intravenous administration. These serious effects require prompt medical evaluation.
Contraindications of Adrenaline
In a genuine life-threatening emergency (anaphylaxis or cardiac arrest), there are no absolute contraindications to Adrenaline, as the benefit of treatment always outweighs the risk.
For non-emergency, elective use (for example, as an additive to local anesthetics), Adrenaline is contraindicated in patients with a known hypersensitivity to Adrenaline or any component of the formulation, and should not be injected into areas supplied by end-arteries with limited collateral circulation (fingers, toes, nose, ears, or genitals) due to the risk of ischemic tissue injury.
Frequently Asked Questions about Adrenaline
What is Adrenaline used for?
Adrenaline is an emergency medicine used to treat severe allergic reactions (anaphylaxis), cardiac arrest, and severe asthma attacks that have not responded to other treatments. It is also added to local anesthetics to prolong their effect.
How quickly does Adrenaline work?
Adrenaline works within minutes when given by injection, which is why it is the first-line emergency treatment for anaphylaxis. Its effects are short-lived, so repeat doses are often needed until emergency medical help arrives.
Can Adrenaline be taken by mouth?
No. Adrenaline is inactivated in the digestive system and must be given by injection (intramuscular, subcutaneous, or intravenous depending on the emergency), never swallowed.
Is Adrenaline safe to use during pregnancy?
Adrenaline should be used during pregnancy only if clearly needed, such as for anaphylaxis or cardiac arrest, where the benefit to the mother (and indirectly the baby) outweighs any potential risk. A physician should always be consulted, though treatment of a true emergency should never be delayed.
What are the common side effects of Adrenaline?
Common effects include anxiety, tremor, palpitations (a racing or pounding heartbeat), headache, sweating, and paleness. These are usually temporary and expected when Adrenaline is used for an emergency.
Are there situations where Adrenaline should not be given?
In a genuine life-threatening emergency such as anaphylaxis or cardiac arrest, there are no absolute contraindications to Adrenaline - it should always be given promptly. For non-emergency uses, Adrenaline should be avoided in people with a known allergy to it and should not be injected into fingers, toes, ears, nose, or genitals.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.