EpiPen Side Effects

Generic name: epinephrine

Medically reviewed by Drugs.com. Last updated on Jul 31, 2023.

Note: This document contains side effect information about epinephrine. Some dosage forms listed on this page may not apply to the brand name EpiPen.

Applies to epinephrine: injection solution. Other dosage forms:

• inhalation aerosol liquid

Serious side effects of EpiPen

Along with its needed effects, epinephrine (the active ingredient contained in EpiPen) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking epinephrine:

Incidence not known

• Abnormal or decreased touch sensation
• anxiety
• arm, back, or jaw pain
• bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
• blurred vision
• chest pain, tightness, heaviness, or discomfort
• cold, pale, or bluish color of the skin of the fingers or toes
• confusion
• difficulty in speaking
• dizziness
• double vision
• fainting
• fast, slow, irregular, pounding, or racing heartbeat or pulse
• headache
• inability to move the arms, legs, or facial muscles
• inability to speak
• nausea
• numbness, tingling, or pain in the fingers
• paleness of the skin
• pounding in the ears
• restlessness
• shakiness in the legs, arms, hands, or feet
• slow speech
• sweating
• trembling or shaking of the hands or feet
• trouble breathing
• unusual tiredness or weakness
• vomiting

Get emergency help immediately if any of the following symptoms of overdose occur while taking epinephrine:

Symptoms of overdose

• Agitation
• coldness of the skin
• confusion
• decreased awareness or responsiveness
• decreased urine output
• depression
• drowsiness
• hostility
• irritability
• lightheadedness
• loss of consciousness
• muscle twitching
• rapid weight gain
• rapid, deep breathing
• seizures
• severe sleepiness
• stomach cramps
• swelling of the face, ankles, or hands
• unusual drowsiness, dullness, or feeling of sluggishness

For Healthcare Professionals

Applies to epinephrine: compounding powder, inhalation aerosol, inhalation solution, injectable kit, injectable solution, intravenous solution, subcutaneous suspension.

General

Due to the lack of randomized, controlled clinical trials for the treatment of anaphylaxis, the true incidence of adverse reactions associated with the systemic use of this drug is difficult to determine. The most commonly reported adverse reactions include anxiety, apprehensiveness, restlessness, tremor, weakness, dizziness, sweating, palpitations, pallor, nausea and vomiting, headache, and/or respiratory difficulties.^[Ref]

Cardiovascular

Frequency not reported: Tachycardia, supraventricular tachycardia, ventricular arrhythmias, myocardial ischemia, myocardial infarction, limb/peripheral ischemia, palpitations, angina, arrhythmias, hypertension, vasoconstriction, ventricular ectopy, ventricular fibrillation, cold extremities, electrocardiogram changes, stress cardiomyopathy^[Ref]

Nervous system

Frequency not reported: Headache, paresthesia, tremor, stroke, central nervous system bleeding, dizziness, cerebral hemorrhage, memory impaired, lightheadedness, psychomotor agitation, tingling, Parkinsonism aggravated, syncope, convulsions, subarachnoid hemorrhage, hemiplegia^[Ref]

Psychiatric

Frequency not reported: Nervousness, excitability, anxiety, apprehension, restlessness, disorientation, panic, hallucinations, psychosis, fear, sleeplessness/insomnia, tenseness, confusion, irritability^[Ref]

Local

Frequency not reported: Extravasation, injection site pallor, coldness at injection site, hypoesthesia at injection site, injury at injection site, local ischemic necrosis^[Ref]

Dermatologic

Frequency not reported: Diaphoresis, pallor, piloerection, skin blanching, skin necrosis with extravasation, necrotizing fasciitis, flushing/redness of skin and face, hyperhidrosis^[Ref]

Metabolic

Frequency not reported: Hypoglycemia, hyperglycemia, insulin resistance, hypokalemia, lactic acidosis, insulin secretion inhibited, metabolic acidosis, anorexia^[Ref]

Respiratory

Frequency not reported: Pulmonary edema, rales, respiratory difficulty, dyspnea, bronchospasm, hypoxia of mucosa^[Ref]

Renal

Frequency not reported: Renal insufficiency^[Ref]

Hypersensitivity

Hypersensitivity side effects have been extremely unusual. Contact dermatitis has been associated with ocularly applied epinephrine (the active ingredient contained in EpiPen) These reactions have typically presented with lid edema and a thick yellow discharge.

Gastrointestinal

Frequency not reported: Nausea, vomiting, bowel necrosis, hypersalivation^[Ref]

Genitourinary

Frequency not reported: Urinary retention, difficult micturition^[Ref]

Hematologic

Frequency not reported: Thrombocytosis^[Ref]

Musculoskeletal

Frequency not reported: Myonecrosis^[Ref]

Other

Frequency not reported: Chest pain, weakness, gas gangrene, asthenia^[Ref]

Ocular

Frequency not reported: Corneal endothelial damage^[Ref]

Endocrine

Frequency not reported: Growth hormone secretion stimulated^[Ref]

Frequently asked questions

• Can you use an expired EpiPen in an emergency?
• Can you bring an EpiPen on a plane?
• What's the mechanism of action for epinephrine?
• How and where is an Epipen injection given?
• What is the difference between Symjepi and EpiPen?
• Norepinephrine vs epinephrine: what's the difference?

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

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