Twinject Side Effects

Generic name: epinephrine

Medically reviewed by Drugs.com. Last updated on May 29, 2024.

Note: This document provides detailed information about Twinject Side Effects associated with epinephrine. Some dosage forms listed on this page may not apply specifically to the brand name Twinject.

Applies to epinephrine: injection solution.

Other dosage forms:

• inhalation aerosol liquid

Precautions

Anaphylaxis is a life-threatening reaction and requires immediate medical attention. Check with your doctor right away, or go to an emergency room as soon as possible, even if you feel better after using this medicine.

Tell your doctor if you develop symptoms of an infection (eg, redness that does not go away, swelling, warmth, or tenderness) at the injection site.

This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

Do not inject this medicine into your buttocks. Epinephrine may not work as well and may cause gas gangrene. Check with your doctor or go to the hospital emergency room right away to get additional treatment.

Do not inject this medicine into your hands or feet. There is already less blood flow to the hands and feet, and epinephrine (the active ingredient contained in Twinject) could make that worse and cause damage to these tissues. If you accidentally inject epinephrine into your hands or feet, check with your doctor or go to the hospital emergency room right away.

This medicine may worsen the condition of patients with heart disease or heart rhythm problems. Check with your doctor right away if you have chest pain or tightness, decreased urine output, dilated neck veins, extreme fatigue, irregular heartbeat, swelling of the face, fingers, feet, or lower legs, trouble breathing, or weight gain. You might also feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat.

This medicine may cause pulmonary edema (fluid in the lungs). Check with your doctor right away if you have chest pain, difficult, fast, or noisy breathing, blue lips and fingernails, pale skin, increased sweating, coughing that sometimes produces a pink frothy sputum, or swelling in the legs and ankles.

Check with your doctor right away if you have bloody urine, a decrease in frequency or amount of urine, an increase in blood pressure, increased thirst, loss of appetite, lower back or side pain, nausea, swelling of the face, fingers, or lower legs, trouble breathing, unusual tiredness or weakness, vomiting, or weight gain. These could be symptoms of a serious kidney problem.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects of Twinject

Along with its needed effects, epinephrine 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:

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, nasal spray, subcutaneous suspension.

General adverse events

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 Twinject) 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]

See also:

Frequently asked questions

• Can you use an expired EpiPen in an emergency?
• Norepinephrine vs epinephrine: what's the difference?
• What's the mechanism of action for epinephrine?
• Can you bring an EpiPen on a plane?
• Does epinephrine cause vasoconstriction?
• How does neffy work?
• How much does Auvi-Q cost compared to EpiPen?

Further information

Twinject side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer