Adrenaline Injection BP 1/1000 (1mg/1ml)

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or nurse.
• If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

The name of your medicine is Adrenaline (Epinephrine) 1:1,000 Solution for Injection.

It will be referred to as Adrenaline Injection for ease hereafter.

1. What Adrenaline Injection is and what it is used for
2. What you need to know before you are given Adrenaline Injection
3. How Adrenaline Injection will be given to you
4. Possible side effects
5. How to store Adrenaline Injection
6. Contents of the pack and other information

• if you are allergic to adrenaline, or to any of the other ingredients of this medicine (listed in section 6).
• when you are in labour
• if you have severe heart disease particularly if it is associated with an increased heart rate
• if you are suffering from any infection, disease or tumour of the brain
• if you have atherosclerosis which is a narrowing, and hardening of the body's blood vessels (your doctor will advise you).

Adrenaline injection should not be used in areas such as fingers, toes, ears, nose or penis, as the blood supply to these areas might become inadequate.

Talk to your doctor or nurse before you are given Adrenaline Injection if:

• you are elderly
• you have problems with your kidneys
• you suffer from any heart problem, particularly if it affects the heart rate or if you suffer from chest pain
• you have problems with your brain e.g. stroke, brain damage or blood vessel disease
• you have an overactive thyroid, diabetes or glaucoma (high pressure in the eye)
• you have phaeochromocytoma (a tumour on the adrenal gland)
• you have low blood levels of potassium or high blood levels of calcium
• you have a tumour on your prostate gland or kidney disease
• you are in shock or have lost a lot of blood
• you are going to have a surgery under general anaesthesia
• you are suffering from high blood pressure.

Tell your doctor or pharmacist if you are taking, or recently taken or might take any other medicines.

A large number of drugs can interact with Adrenaline Injection which can significantly alter their effects.

These drugs include:

• monoamine oxidase inhibitors (MAOI) or tricyclic antidepressants both used for depression
• guanethidine, used for the rapid control of blood pressure
• diuretics (“water tablets”)
• inhaled general anaesthetics, such as halothane
• medicines to raise or lower your blood pressure including betablockers, e.g. propranolol, atenolol, bisoprolol, phentolamine
• anti-diabetic drugs like insulin or oral hypoglycaemic agents (e.g. glipizide)
• aminophylline and theophylline (medicines to help you breathe)
• corticosteroids (medicines used to treat inflammatory conditions in your body such as asthma or arthritis)
• antihistamines (for example: diphenhydramine), used for the treatment of allergies
• medicines used to treat mental illness like chlorpromazine, pericyazine or fluphenazine
• medicines used to treat an underactive thyroid gland
• oxytocin (used to induce labor at term and to control bleeding after delivery)
• any cough or cold remedies (sympathomimetics).

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before using this medicine.

Adrenaline should only be used during pregnancy and breast-feeding if considered essential by your doctor.

You should not drive or use machinery if you are affected by the administration of Adrenaline Injection.

This medicine contains sodium metabisulphite, a preservative. This may rarely cause severe allergic (hypersensitivity) reactions and wheezing. This medicinal product contains less than 1mmol sodium (23mg) per dose (essentially ‘sodium-free’).

The following doses of adrenaline 1/1,000 are recommended:

Age Dose

Over 12 years 0.5 mg IM (0.5ml 1:1000 solution)

6 - 12 years 0.3 mg IM (0.3ml 1:1000 solution)

6 months - 6 years 0.15 mg IM (0.15ml 1:1000 solution)

Under 6 months 0.01mg/kg IM (0.01ml/kg 1:1000 solution)

If necessary, these doses may be repeated at 5-15 -minute intervals according to blood pressure, pulse and respiratory function.

A small volume syringe should be used.

• allergic reactions although serious allergic reactions are rare
• any sudden wheeziness, difficulty in breathing, swelling of the eyelids, face or lips, rash or itching (especially affecting your whole body).
• Symptoms of chest pain, shortness of breath, nausea or an irregular heartbeat, especially if you are feeling stressed. These can be signs of a condition known as stress cardiomyopathy.

Not known: frequency cannot be estimated from the available data:

• headache
• dizziness
• feelings of anxiety or fear or restlessness
• trembling
• insomnia, confusion, irritability
• abnormal mood or behaviour
• a dry mouth or producing too much saliva
• weakness or sweating
• changes in the rhythm and speed of the heart
• high blood pressure
• coldness of the arms or legs
• breathlessness
• reduced appetite, feeling sick or being sick
• repeated injections may damage tissues at the site of the injection
• difficulty of not being able to pass water
• metabolic acidosis (an imbalance of certain constituents in your blood) may occur
• there may be some tissue damage at the site of injection after repeated injections of adrenaline
• increase in tremors and rigidity in patients suffering from a condition called Parkinsonian syndrome
• bleeding in the head
• paralysis of one half of the body
• increased sugar levels in the blood
• breakdown of fat in the body.

If you get any side effects, talk to your doctor or pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via Yellow Card Scheme. Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store .

By reporting side effects you can help provide more information on the safety of this medicine.

The active substance is adrenaline. Each 1ml contains 1mg adrenaline (epinephrine) as the acid tartrate.

The other ingredients are sodium metabisulphite (E223), sodium chloride, sodium hydroxide or hydrochloric acid in water for injections.

Adrenaline Injection is a clear colourless, aqueous, sterile solution for injection, available in 1ml glass ampoules, packed in boxes containing 10 ampoules.