Epipen (Epinephrine Auto Injector) Drug Information: Side Effects and Drug Interactions

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May 27, 2012

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Bee and Wasp Sting »

Insect stings overview

Bee and wasp stings are common causes of medical problems. Bees and wasps, together with fire ants, are all related insects that belong to the Hymenoptera order. Bee and wasp stings can cause significant reactions, ranging from localized pain and swelling to serious and even potentially fatal conditions. At least 40 deaths occur each year in the U.S. as a result of bee or wasp stings.

What are the types of wasps?

There are over 25,000 species of wasps found throughout the world. Some of the most common wasps include:

The yellow jacket and hornet, both of which live in groups, or colonies, in temperate climates.
Yellow jackets, which have black and yellow stripes on the abdomen, form underground nests.
Hornets are predominantly black with some yellow markings on the head and thorax. Hornets form paper-like nests that are attached to trees, bush...

Read the Bee and Wasp Sting article »

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SIDE EFFECTS

Adverse reactions to epinephrine include transient, moderate anxiety; apprehensiveness; restlessness; tremor; weakness; dizziness; sweating; palpitations; pallor; nausea and vomiting; headache; and/or respiratory difficulties. These symptoms occur in some persons receiving therapeutic doses of epinephrine, but are more likely to occur in patients with hypertension or hyperthyroidism. Arrhythmias, including fatal ventricular fibrillation, have been reported in patients with underlying cardiac disease or certain drugs (see PRECAUTIONS: DRUG INTERACTIONS). Rapid rises in blood pressure have produced cerebral hemorrhage, particularly in elderly patients with cardiovascular disease. Angina may occur in patients with coronary artery disease. The potential for epinephrine to produce these types of adverse reactions does not contraindicate its use in an acute life-threatening allergic reaction.

Accidental injection into the digits, hands or feet may result in loss of blood flow to the affected area (see WARNINGS). Adverse events experienced as a result of accidental injections may include increased heart rate, local reactions including injection site pallor, coldness and hypoaesthesia or injury at the injection site resulting in bruising, bleeding, discoloration, erythema or skeletal injury.

DRUG INTERACTIONS

Patients who receive epinephrine while concomitantly taking cardiac glycosides or diuretics should be observed carefully for the development of cardiac arrhythmias.

The effects of epinephrine may be potentiated by tricyclic antidepressants, monoamine oxidase inhibitors, levothyroxine sodium, and certain antihistamines, notably chlorpheniramine, tripelennamine and diphenhydramine.

The cardiostimulating and bronchodilating effects of epinephrine are antagonized by beta-adrenergic blocking drugs, such as propranolol. The vasoconstricting and hypertensive effects of epinephrine are antagonized by alpha-adrenergic blocking drugs, such as phentoloamine. Ergot alkaloids may also reverse the pressor effects of epinephrine.

Last reviewed on RxList: 7/6/2009
This monograph has been modified to include the generic and brand name in many instances.