Adrenaline (Epinephrine) Injection (1:1000) for Anaphylaxis (glass prefilled syringe)

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

This medicine will be referred to as Adrenaline Injection in the rest of this leaflet.

1. What Adrenaline Injection is and what it is used for
2. What you need to know before you use Adrenaline Injection
3. How Adrenaline Injection is given
4. Possible side effects
5. How to store Adrenaline Injection
6. Contents of the pack and other information

• are allergic to adrenaline or any of the other ingredients of this medicine listed in section 6.
• have severe heart disease particularly if it is associated with an increased heart rate.
• are suffering from any infection, disease or tumour of the brain
• have atherosclerosis which is a narrowing, and hardening of the body’s blood vessels (your doctor will advise you).
• are in shock (other than that caused by a sudden life threatening reaction).
• are suffering from glaucoma (increased pressure in the eye).
• are having or are about to have an operation under general anaesthetic.
• are in labour.

Adrenaline injection should not be used in areas such as fingers, toes, ears, nose or penis, as the blood supply to these areas might become inadequate.

Talk to your doctor or pharmacist before being given Adrenaline Injection if

• you are elderly
• you suffer from any heart problem, particularly if it affects the heart rate or if you suffer from chest pain
• you have a condition called congenital long QT syndrome or problems with heart rhythm
• you have problems with your brain e.g. stroke, brain damage or blood vessel disease
• you have an overactive thyroid, diabetes or glaucoma (high pressure in the eye)
• you have phaeochromocytoma (a tumour on the adrenal gland)
• you have low blood levels of potassium or high blood levels of calcium
• you have a tumour on your prostate gland or kidney disease
• you are in shock or have lost a lot of blood
• you are going to have a surgery under general anaesthesia
• you are suffering from high blood pressure

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

Medicines that may interact with Adrenaline Injection include:

• monoamine oxidase inhibitors (MAOI) or tricyclic antidepressants both used for depression such as imipramine
• guanethidine, used for the rapid control of blood pressure
• diuretics (“water tablets”)
• inhaled general anaesthetics, such as halothane
• medicines to raise or lower your blood pressure including betablockers, e.g. propranolol, atenolol, bisoprolol, phentolamine
• anti-diabetic drugs like insulin or oral hypoglycaemic agents (e.g. glipizide)
• aminophylline and theophylline (medicines to help you breathe)
• corticosteroids (medicines used to treat inflammatory conditions in your body such as asthma or arthritis)
• antihistamines (for example: diphenhydramine), used for the treatment of allergies
• medicines used to treat mental illness like chlorpromazine, pericyazine or fluphenazine
• medicines used to treat an underactive thyroid gland
• oxytocin (used to induce labour at term and to control bleeding after delivery)
• any cough or cold remedies (sympathomimetics).
• ergot alkaloids(drugs used to treat migraine)

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before using this medicine. Adrenaline Injection should only be used during pregnancy and breast-feeding if considered essential by your doctor.

You should not drive or use machinery if you are affected by the administration of Adrenaline Injection.

The product also contains Sodium Metabisulphite which may cause allergic (hypersensitive) type reactions in some people, which can lead to breathing difficulties or collapse. People with a history of asthma or allergies are most likely to experience these problems.

Adults: 500 micrograms (0.5 ml) of 1:1000 adrenaline solution given by injection into the muscle (intramuscular)

Children: Volume of 1:1000 adrenaline to administer is shown in brackets.

Age Dose

Over 12 years 0.5 mg IM (0.5ml 1:1000 solution)

6 - 12 years 0.3 mg IM (0.3ml 1:1000 solution)

6 months - 6 years 0.15 mg IM (0.15ml 1:1000 solution)

Under 6 months 0.01mg/kg IM (0.01ml/kg 1:1000 solution)

Repeat the intramuscular dose if there is no improvement in the patients condition. Further doses can be given at 5 minute intervals according to the patient’s response.

As this medicine will be given to you whilst you are in hospital, it is unlikely that you will be given too little or too much, however, tell your doctor or nurse if you have any concerns.

• allergic reactions although serious allergic reactions are rare
• any sudden wheeziness, difficulty in breathing, swelling of the eyelids, face or lips, rash or itching (especially affecting your whole body).

Other side effects (Not known: frequency cannot be estimated from the available data):

• headache
• dizziness
• feelings of anxiety or fear or restlessness
• trembling
• insomnia, confusion, irritability
• abnormal mood or behaviour
• a dry mouth or producing too much saliva
• weakness or sweating
• changes in the rhythm and speed of the heart
• high blood pressure
• coldness of the arms or legs
• breathlessness
• reduced appetite, feeling sick or being sick
• repeated injections may damage tissues at the site of the injection
• difficulty of not being able to pass water
• metabolic acidosis (an imbalance of certain constituents in your blood) may occur
• there may be some tissue damage at the site of injection after repeated injections of adrenaline
• increase in tremors and rigidity in patients suffering from a condition called Parkinsonian syndrome
• bleeding in the head
• paralysis of one half of the body
• increased sugar levels in the blood
• breakdown of fat in the body.

If you get any side effects, talk to your doctor or pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via Yellow Card Scheme. Website: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.

The active ingredient is Adrenaline (Epinephrine) (as acid tartrate).

Each 1ml solution for injection contains 1mg of adrenaline (epinephrine) as the acid tartrate.

The other ingredients are Sodium Chloride, Sodium Metabisulphite and Water for Injections. Dilute Hydrochloric acid may be added to adjust the acidity.

Adrenaline Injection is a clear, colourless solution supplied in a pre-filled syringe with a needle.