Skip to Content

Epinephrine Pregnancy and Breastfeeding Warnings

Epinephrine is also known as: Adrenaclick, Adrenalin, Adrenalin Chloride, Ana-Guard, Asthmahaler, Auvi-Q, Bronchial Mist with Pump, Bronitin, Bronkaid Mist, EPIsnap, Epi EZ Pen, EpiPen, EpiPen 2-Pak, EpiPen Auto-Injector, EpiPen JR 2-Pak, EpiPen JR Auto-Injector, EpiPen Jr, Medihaler-Epi, Primatene Mist, Sus-Phrine Injection, Symjepi, Twinject

Medically reviewed by Drugs.com. Last updated on Feb 2, 2019.

Epinephrine Pregnancy Warnings

Use only if the potential benefit justifies the potential risk to the fetus.

AU TGA pregnancy category: A
US FDA pregnancy category: Not assigned

Comments:
-Use with caution during labor and delivery; avoid use during second stage of labor.
-Avoid use in obstetrics when maternal blood pressure exceeds 130/80 mmHg.
-According to some authorities, this drug is considered first choice for anaphylaxis treatment during pregnancy; use in the same manner as for non-pregnant patients.
-Patients should seek immediate medical care in addition to using this medication.

Animal studies have revealed evidence of teratogenicity (including gastroschisis and lethality) when given during organogenesis at doses 7 times and higher the maximum recommended human intramuscular and subcutaneous dose. Injection of this drug may also cause fetal tachycardia, cardiac irregularities, extrasystoles, and increased heart sounds. There are no controlled data in human pregnancy.

Anaphylaxis during pregnancy may lead to hypoxic-ischemic encephalopathy and permanent central nervous system damage or death for the mother and the fetus/neonate. Anaphylaxis during pregnancy is estimated at 3 per 1000 deliveries.

Use with caution during labor and delivery; while this drug improves maternal hypotension associated with anaphylaxis, it may result in uterine vasoconstriction, decreased uterine blood flow, and fetal anoxia. Use should be avoided during the second stage of labor as this drug may reduce uterine contractions and cause a prolonged period of uterine atony with hemorrhage.

AU TGA pregnancy category A: Drugs which have been taken by a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the fetus having been observed.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

See references

Epinephrine Breastfeeding Warnings

High IV doses may reduce milk production and milk letdown. Studies in non-nursing subjects and women with hyperprolactinemia who received an IV infusion of this drug demonstrated decreased serum prolactin concentrations. Animal studies indicate that intra-arterial administration can decrease serum oxytocin and inhibit milk ejection. However, due to its poor oral bioavailability and short half-life, any amount of this drug present in milk is unlikely to affect the infant.

Caution is recommended; according to some experts, use is not recommended.

Excreted into human milk: Yes

Comments:
-The effects in the nursing infant or milk production are unknown.
-According to some authorities, this drug is considered first choice for anaphylaxis treatment during breastfeeding; use in the same manner as for non-breastfeeding patients.

See references

References for pregnancy information

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. "Product Information. EpiPen (EPINEPHrine)." Dey Laboratories, Napa, CA.
  4. "Product Information. Adrenalin (EPINEPHrine)." A-S Medication Solutions, Chicago, IL.
  5. "Product Information. Adrenaclick Two-Pack (EPINEPHrine)." Amedra Pharmaceuticals LLC, Middlesex, NJ.
  6. "Product Information. Auvi-Q (EPINEPHrine)." sanofi-aventis, Bridgewater, NJ.
  7. "Product Information. Epinephrine (EPINEPHrine)." Physicians Total Care, Tulsa, OK.

References for breastfeeding information

  1. "Product Information. Adrenalin (EPINEPHrine)." A-S Medication Solutions, Chicago, IL.
  2. United States National Library of Medicine "Toxnet. Toxicology Data Network. Available from: URL: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT." ([cited 2013 -]):
  3. "Product Information. Adrenaclick Two-Pack (EPINEPHrine)." Amedra Pharmaceuticals LLC, Middlesex, NJ.
  4. "Product Information. Epinephrine (EPINEPHrine)." Physicians Total Care, Tulsa, OK.
  5. "Product Information. Auvi-Q (EPINEPHrine)." sanofi-aventis, Bridgewater, NJ.
  6. Cerner Multum, Inc. "Australian Product Information." O 0
  7. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  8. "Product Information. EpiPen (EPINEPHrine)." Dey Laboratories, Napa, CA.

Further information

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

Hide