epinephrine

Trade name: levophed

Small moleculeapproved

Approved

Nov 19, 1948

Epinephrine is a sympathomimetic catecholamine. It acts as a naturally occurring agonist at both alpha and beta-adrenergic receptors. Three pharmacologic types have been identified: alpha 1-, alpha 2-, and beta-adrenergic receptors. Each of these has three subtypes, characterized by both structural and functional differences. The alpha 2 and beta receptors are coupled negatively and positively, respectively, to adenylyl cyclase via Gi or Gs regulatory proteins, and the alpha 1 receptors modulate phospholipase C via the Go protein. Subtype expression is regulated at the level of the gene, the mRNA, and the protein through various transcriptional and postsynthetic mechanisms. Through its action on alpha-adrenergic receptors, epinephrine lessens the vasodilation and increased vascular permeability that occurs during anaphylaxis, which can lead to loss of intravascular fluid volume and hypotension. Through its action on beta-adrenergic receptors, epinephrine causes bronchial smooth muscle relaxation and helps alleviate bronchospasm, wheezing and dyspnea that may occur during anaphylaxis. Epinephrine also alleviates pruritus, urticaria, and angioedema and may relieve gastrointestinal and genitourinary symptoms associated with anaphylaxis because of its relaxer effects on the smooth muscle of the stomach, intestine, uterus and urinary bladder. Epinephrine increases glycogenolysis, reduces glucose up take by tissues, and inhibits insulin release in the pancreas, resulting in hyperglycemia and increased blood lactic acid. — NCATS

Clinical trial activity

574 trials · 420 clinical orgs · 52 marketing orgs

Phase 1
55
Phase 2
105
Phase 3
65
Phase 4
187

Earliest trial started Oct 1, 1999 (NCT00148278)

Timeline

1890s

  1. Apr 20, 1896

    Evidence of US Marketing

1940s

  1. Nov 19, 1948

    Fresenius — Earliest FDA Approval

  2. Nov 19, 1948

    Dentsply International — Marketing Organization

  3. Nov 19, 1948

    Fresenius — Marketing Organization

  4. Nov 19, 1948

    Fresenius — NDA Organization

  5. Nov 19, 1948

    Dentsply International — NDA Secondary Org

1950s

  1. Jun 8, 1951

    Forest Laboratories — NDA Secondary Org

  2. Mar 9, 1956

    3M — NDA Secondary Org

1960s

  1. Nov 18, 1965

    AstraZeneca — NDA Secondary Org

  2. Nov 8, 1967

    Wyeth — NDA Secondary Org

  3. Nov 8, 1967

    American Home Products — NDA Secondary Org

  4. Aug 11, 1969

    Sterling Drug — NDA Secondary Org

  5. Aug 11, 1969

    Sterling-Winthrop — NDA Secondary Org

1970s

  1. Feb 23, 1972

    Belmora — Marketing Organization

  2. Mar 13, 1972

    West-Ward Pharmaceutical — Marketing Organization

  3. Nov 28, 1972

    AstraZeneca — Marketing Organization

  4. Dec 20, 1972

    Abbott — Marketing Organization

  5. Nov 26, 1973

    Belmar Pharmacy — Marketing Organization

  6. Feb 20, 1974

    Watson Pharmaceuticals — Marketing Organization

  7. Mar 18, 1975

    Del Laboratories — Marketing Organization

  8. Jan 16, 1976

    Carlisle — Marketing Organization

1980s

  1. Feb 4, 1980

    International Medication — Marketing Organization

  2. Sep 9, 1980

    Septodont — Marketing Organization

  3. Aug 17, 1983

    Pharmaton — Marketing Organization

  4. May 23, 1984

    Armstrong Pharmaceuticals — NDA Secondary Org

  5. May 23, 1984

    Armstrong Pharmaceuticals — Marketing Organization

  6. Jan 22, 1985

    Deproco — Marketing Organization

  7. Sep 13, 1985

    Hospira — Marketing Organization

  8. Dec 22, 1987

    Mylan — NDA Secondary Org

  9. Dec 22, 1987

    Viatris — Marketing Organization

1990s

  1. Feb 26, 1993

    Kodak — Marketing Organization

  2. Dec 21, 1995

    iOMEDICO AG — Marketing Organization

  3. Dec 21, 1995

    iOMEDICO AG — NDA Secondary Org

  4. Jan 1, 1999

    Earliest Phase 2 Sponsor(trial)

2000s

  1. Apr 3, 2000

    Deproco — NDA Secondary Org

  2. Jan 1, 2003

    Earliest Phase 3 Sponsor(trial)

  3. May 30, 2003

    Impax Laboratories — NDA Secondary Org

  4. May 6, 2004

    Vyteris — Marketing Organization

  5. May 6, 2004

    Vyteris — NDA Secondary Org

  6. Oct 26, 2004

    Empi — Marketing Organization

  7. Oct 26, 2004

    Empi — NDA Secondary Org

  8. Jan 1, 2005

    Earliest Phase 1 Sponsor(trial)

2010s

  1. Feb 26, 2010

    Pierrel Research — Marketing Organization

  2. Feb 26, 2010

    Pierrel Research — NDA Secondary Org

  3. Aug 10, 2012

    Kaleo — NDA Secondary Org

  4. Dec 7, 2012

    Par Pharmaceuticals — NDA Secondary Org

  5. Dec 7, 2012

    Endo Pharmaceuticals — Marketing Organization

  6. Dec 7, 2012

    PH HEALTH — Marketing Organization

  7. Jul 29, 2014

    Belcher Pharmaceuticals — NDA Secondary Org

  8. Jul 29, 2014

    Belcher Pharmaceuticals — Marketing Organization

  9. Jul 29, 2014

    BPI — Marketing Organization

  10. Jul 29, 2014

    BPI — NDA Secondary Org

  11. Jun 15, 2017

    Adamis Pharmaceuticals Corporation — NDA Secondary Org

  12. Jul 11, 2017

    HansaBioMed — Marketing Organization

  13. Jul 11, 2017

    Lonza — Marketing Organization

  14. Nov 29, 2017

    Hospira — NDA Secondary Org

  15. Jul 6, 2018

    Lutipold — Marketing Organization

  16. Jul 6, 2018

    Sankyo — Marketing Organization

  17. Jul 6, 2018

    Daiichi Sankyo — Marketing Organization

  18. Aug 16, 2018

    Teva — Marketing Organization

  19. Nov 7, 2018

    Allergan PLC (2015) — NDA Secondary Org

  20. Nov 5, 2019

    Pfizer — NDA Secondary Org

2020s

  1. Mar 17, 2021

    Pfizer — Marketing Organization

  2. Sep 8, 2021

    B. Braun — Marketing Organization

  3. Aug 15, 2022

    International Medication — NDA Secondary Org

  4. Apr 21, 2023

    Bristol-Myers Squibb — NDA Secondary Org

  5. Aug 9, 2024

    ARS PHARMS OPERATION — Marketing Organization

  6. Feb 6, 2025

    Gland Pharma Ltd — Marketing Organization

  7. Feb 28, 2025

    Baxalta — Marketing Organization

  8. Oct 14, 2025

    Amneal Pharmaceuticals — Marketing Organization

  9. May 29, 2026

    Hikma — Marketing Organization

Indications

Approved for

Studied for

Mechanism of action

Combination products

  • citanest forte dental

    with prilocaine

    Also known as citanest forte

  • duranest

    with etidocaine

  • marcaine hydrochloride w/ epinephrine preservative free

    with levobupivacaine

    Also known as bupivacaine hydrochloride and epinephrine, marcaine hydrochloride w/ epinephrine, sensorcaine

  • septocaine

    with articaine

    Also known as orabloc, ultacan, ultacan forte

  • xylocaine dental with epinephrine

    with lidocaine

    Also known as alphacaine hydrochloride w/ epinephrine, iontocaine, lidocaton, lidosite topical system, lignospan forte, lignospan standar, octocaine, xylocaine w/ epinephrine

Approval history

  • approvedNov 19, 1948
  • approvedApr 20, 1896

Chemistry & pharmacology

Loading structure…

SMILES

CNC[C@H](O)c1ccc(O)c(O)c1
Mol. weight
183.21 g/mol
Lipinski Ro5
Pass
Rule of 3
No
Chirality
Single Stereoisomer
Inorganic
No
Polymer
No
Delivery
Parenteral, Topical
Availability
Over the Counter

Oral

No

Parenteral

Yes

Topical

Yes

Sources

Also known as

  • (-)-3,4-dihydroxy-alpha-((methylamino)methyl)benzyl alcohol
  • (-)-3,4-dihydroxy-alpha-((methylamino)methyl)benzyl alcohol
  • 4-[(1r)-1-hydroxy-2-(methylamino)ethyl]-1,2-benzenediol
  • 4-[(1r)-1-hydroxy-2-(methylamino)ethyl]-1,2-benzenediol
  • adrenaclick
  • adrenaclick
  • adrenalilne
  • adrenalin
  • adrenalin
  • adrenaline
  • adrenaline
  • adrenaline
  • adrenaline
  • (-)-adrenaline
  • (-)-adrenaline
  • (-)-adrenaline
  • (−)-adrenaline
  • (−)-adrenaline
  • adrenaline bitartrate
  • adrenaline bitartrate
  • adren co
  • ana-guard
  • ana-guard
  • ana-kit
  • ana-kit
  • anapen
  • anaphylactic shock drug kit
  • asma-vydrin
  • asthmahaler
  • asthmahaler
  • auvi-q
  • auvi-q
  • bronkaid mist
  • bronkaid mist
  • brovon
  • emerade
  • ephephrine
  • epi e z pen jr
  • epi e z pen jr
  • epinefrin
  • epinefrin
  • epinefrina
  • epinefrina
  • epinephrin
  • epinephrin
  • epinephrin
  • epinephrine
  • epinephrine
  • epinephrine
  • epinephrine
  • epinephrine
  • epinephrine
  • epinephrine
  • epinephrine
  • epinephrine
  • epinephrine
  • epinephrine
  • (-)-epinephrine bitartrate
  • (-)-epinephrine bitartrate
  • epinephrine bitartrate
  • epinephrine bitartrate
  • epinephrine bitartrate
  • epinephrine bitartrate
  • epinephrine hcl
  • epinephrine hcl
  • epinephrine hydrochloride
  • epinephrinum
  • epinephrinum
  • epipen
  • epipen
  • epipen
  • epipen e z pen
  • epipen e z pen
  • epipen jr
  • epipen jr
  • epipen jr.
  • epipen jr.
  • eppy
  • eppy
  • gppe inh soln
  • jext
  • l-adrenaline
  • l-adrenaline
  • l-epinephrine
  • l-epinephrine
  • levoepinephrine
  • levoepinephrine
  • levo-methylaminoethanolcatechol
  • levo-methylaminoethanolcatechol
  • nephridine
  • primatene
  • primatene
  • primatene
  • primatene mist
  • primatene mist
  • (r)-(-)-adnephrine
  • (r)-(-)-adnephrine
  • (r)-(-)-adrenaline
  • (r)-(-)-adrenaline
  • (r)-(−)-adrenaline
  • (r)-(−)-adrenaline
  • renoform
  • (-)-(r)-epinephrine
  • (-)-(r)-epinephrine
  • (r)-(-)-epinephrine
  • (r)-(-)-epinephrine
  • (r)-(-)-epirenamine
  • (r)-(-)-epirenamine
  • riddobron
  • riddofan
  • rybarvin
  • simplene
  • simplene
  • soln made to rybarvin for
  • suprarenin
  • sus-phrine
  • sus-phrine
  • sus-phrine sulfite-free
  • sus-phrine sulfite-free
  • twinject
  • twinject
  • twinject 0.15
  • twinject 0.15
  • twinject 0.3
  • twinject 0.3
  • vasoconstrictine

Clinical trials

NCT IDPhaseStart dateSponsor(s)
NCT07267650N/AJan 1, 2026Turgutlu State Hospital
NCT07231614Phase 4Dec 20, 2025Universidad Austral de Chile
NCT07222241N/ADec 1, 2025University of Pennsylvania
NCT07301528N/ADec 1, 2025Kutahya City Hospital
NCT07097493Phase 4Dec 1, 2025Atrium Medical Center, Wake Forest University
NCT07068243Phase 2Nov 30, 2025Duke University
NCT07092566Phase 3Nov 14, 2025University of North Carolina at Chapel Hill, Wake Forest University
NCT07228325Phase 1/Phase 2 (Phase 2)Nov 3, 2025Nasus Pharma, Pharma Medica
NCT07210320Phase 1Oct 24, 2025Insignis Therapeutics, Inc., Washington University in St. Louis
NCT07213635Phase 4Oct 20, 2025University of North Carolina at Chapel Hill
NCT07144267N/AOct 1, 2025Mansoura University
NCT07113600N/AAug 31, 2025Cairo University
NCT07038746Phase 1Aug 25, 2025Kokua Pharma Inc.
NCT07089251Phase 4Jul 15, 2025King Abdullah Medical City
NCT07073209N/AJul 10, 2025Cornell University, New York Presbyterian Hospital
NCT06927999Phase 2Jul 9, 2025ARS Pharmaceuticals, Inc.
NCT07066306N/AJun 21, 2025Bezmialem University
NCT07045701Phase 2/Phase 3 (Phase 3)Jun 12, 2025Hebrew University, Nasus Pharma
NCT06960317N/AJun 4, 2025University of California, San Diego
NCT07273526N/AJun 1, 2025University of Health Sciences Lahore
Showing 20 of 574 trials
Page 1 / 29

Organizations

Research & Development (420)

OrganizationOrg typeTrialsAs lead sponsorPhasesEarliest year
Aarhus UniversityAcademic/Hospital151142001
Cairo UniversityAcademic/Hospital151342016
University of TorontoAcademic/Hospital111032009
Amphastar PharmaceuticalsFor profit101032009
University of CopenhagenAcademic/Hospital10842001
Assiut UniversityAcademic/Hospital9932016
Wake Forest UniversityAcademic/Hospital9942015
Mayo ClinicAcademic/Hospital7732006
Seoul National UniversityAcademic/Hospital7732008
University of California, IrvineAcademic/Hospital7642005
University of California, San DiegoAcademic/Hospital7722018
Mansoura UniversityAcademic/Hospital6622014
Orebro UniversityAcademic/Hospital6532005
University of Western OntarioAcademic/Hospital6432013
Ain Shams UniversityAcademic/Hospital5532014
Capital Medical UniversityAcademic/Hospital5422016
Chinese University of Hong KongAcademic/Hospital5532015
Cornell UniversityAcademic/Hospital5422005
Hospitalsenhed MidtAcademic/Hospital5322014
Indiana UniversityAcademic/Hospital5522003
420 organizations
Page 1 / 21

Marketing (69)

OrganizationOrg typeRelationshipDate
3MFor profitNDA2Mar 9, 1956
ARS PHARMS OPERATIONFor profitMKTGAug 9, 2024
AbbottFor profitMKTGDec 20, 1972
Adamis Pharmaceuticals CorporationFor profitNDA2Jun 15, 2017
Allergan PLC (2015)For profitNDA2Nov 7, 2018
American Home ProductsFor profitNDA2Nov 8, 1967
Amneal PharmaceuticalsFor profitMKTGOct 14, 2025
Armstrong PharmaceuticalsFor profitNDA2May 23, 1984
Armstrong PharmaceuticalsFor profitMKTGMay 23, 1984
AstraZenecaFor profitMKTGNov 28, 1972
AstraZenecaFor profitNDA2Nov 18, 1965
B. BraunFor profitMKTGSep 8, 2021
B. BraunFor profitSYNSep 8, 2021
BPIFor profitMKTGJul 29, 2014
BPIFor profitNDA2Jul 29, 2014
BaxaltaFor profitMKTGFeb 28, 2025
Belcher PharmaceuticalsFor profitNDA2Jul 29, 2014
Belcher PharmaceuticalsFor profitMKTGJul 29, 2014
Belmar PharmacyFor profitMKTGNov 26, 1973
BelmoraAcademic/HospitalMKTGFeb 23, 1972
Bristol-Myers SquibbFor profitNDA2Apr 21, 2023
CarlisleFor profitMKTGJan 16, 1976
Daiichi SankyoFor profitMKTGJul 6, 2018
Del LaboratoriesFor profitMKTGMar 18, 1975
Dentsply InternationalFor profitMKTGNov 19, 1948
Dentsply InternationalFor profitNDA2Nov 19, 1948
DeprocoFor profitMKTGJan 22, 1985
DeprocoFor profitNDA2Apr 3, 2000
EmpiFor profitMKTGOct 26, 2004
EmpiFor profitNDA2Oct 26, 2004
Endo PharmaceuticalsFor profitMKTGDec 7, 2012
Forest LaboratoriesFor profitNDA2Jun 8, 1951
FreseniusFor profitMKTGNov 19, 1948
FreseniusFor profitNDANov 19, 1948
Gland Pharma LtdFor profitMKTGFeb 6, 2025
HansaBioMedFor profitMKTGJul 11, 2017
HikmaFor profitMKTGMay 29, 2026
HospiraFor profitNDA2Nov 29, 2017
HospiraFor profitMKTGSep 13, 1985
Impax LaboratoriesFor profitNDA2May 30, 2003
International MedicationFor profitMKTGFeb 4, 1980
International MedicationFor profitSYNApr 24, 2020
International MedicationFor profitNDA2Aug 15, 2022
KaleoFor profitNDA2Aug 10, 2012
KodakFor profitMKTGFeb 26, 1993
LonzaFor profitMKTGJul 11, 2017
LutipoldFor profitMKTGJul 6, 2018
MylanFor profitNDA2Dec 22, 1987
PH HEALTHFor profitMKTGDec 7, 2012
Par PharmaceuticalsFor profitNDA2Dec 7, 2012
PfizerFor profitNDA2Nov 5, 2019
PfizerFor profitMKTGMar 17, 2021
PharmatonFor profitMKTGAug 17, 1983
Pierrel ResearchFor profitMKTGFeb 26, 2010
Pierrel ResearchFor profitNDA2Feb 26, 2010
SankyoFor profitMKTGJul 6, 2018
SeptodontFor profitMKTGSep 9, 1980
SeptodontFor profitSYNAug 30, 2011
Sterling DrugFor profitNDA2Aug 11, 1969
Sterling-WinthropFor profitNDA2Aug 11, 1969
TevaFor profitMKTGAug 16, 2018
ViatrisFor profitMKTGDec 22, 1987
VyterisFor profitMKTGMay 6, 2004
VyterisFor profitNDA2May 6, 2004
Watson PharmaceuticalsFor profitMKTGFeb 20, 1974
West-Ward PharmaceuticalFor profitMKTGMar 13, 1972
WyethFor profitNDA2Nov 8, 1967
iOMEDICO AGFor profitMKTGDec 21, 1995
iOMEDICO AGFor profitNDA2Dec 21, 1995