Epinephrine is the first line-medication of choice for treatment of anaphylaxis; it should be used in the same manner in pregnant and non-pregnant patients. Hence, if blanching occurs, consider changing the infusion site at intervals to allow the effects of local vasoconstriction to subside.There is potential for gangrene in a lower extremity when infusions of catecholamine are given in an ankle vein.Because individual response to epinephrine may vary significantly, monitor blood pressure frequently and titrate to avoid excessive increases in blood pressure.Patients receiving monoamine oxidase inhibitors (MAOI) or antidepressants of the triptyline or imipramine types may experience severe, prolonged hypertension when given epinephrine.Epinephrine increases cardiac output and causes peripheral vasoconstriction, which may result in pulmonary edema.Epinephrine constricts renal blood vessels, which may result in oliguria or renal impairment.Epinephrine may induce cardiac arrhythmias and myocardial ischemia in patients, especially patients suffering from coronary artery disease, or cardiomyopathy.Epinephrine Injection, USP contains sodium bisulfite which may cause mild to severe allergic reactions including anaphylaxis or asthmatic episodes in susceptible individuals. It is supplied in a 10 ml polypropylene Pre-filled Syringe with a polypropylene tip cap and tamper proof seal, individually packaged in a transparent blister pack. Avoid epinephrine in obstetrics when maternal blood pressure exceeds 130/80 mmHg.In an embryofetal development study with pregnant rabbits dosed during the period of organogenesis (on days 3 to 5, 6 to 7 or 7 to 9 of gestation), epinephrine caused teratogenic effects (including gastroschisis) at doses approximately 15 times the maximum recommended intramuscular, subcutaneous, or intravenous dose (on a mg/m,In an embryofetal development study, pregnant mice were administered epinephrine (0.1 to 10 mg/kg/day) on Gestation Days 6 to 15. Blanching along the course of the infused vein, sometimes without obvious extravasation, may be attributed to vasa vasorum constriction with increased permeability of the vein wall, permitting some leakage. In dosage sufficient to reduce uterine contractions, the drug may cause a prolonged period of uterine atony with hemorrhage. Therefore, for the treatment of anaphylaxis, consider starting with a lower dose to take into account potential concomitant disease or other drug therapy.Clinical studies of epinephrine for the treatment of hypotension associated with septic shock did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Myocardial ischemia and infarction, cardiomyopathy, extreme pallor and coldness of the skin, metabolic acidosis due to elevated blood lactic acid levels, and renal insufficiency have also been reported.Epinephrine is rapidly inactivated in the body and treatment following overdose with epinephrine is primarily supportive. Some of these patients experienced a stroke.Carefully monitor the blood pressure of individuals who have received both Emerphed and an oxytocic.These drugs augment the pressor effect of ephedrine.Carefully monitor the blood pressure of individuals who have received both Emerphed and any of these drugs.These drugs antagonize the pressor effect of ephedrine.α-adrenergic antagonists, β-adrenergic receptor antagonists, reserpine, quinidine, mephentermine.Emerphed may inhibit the neuron blockage produced by guanethidine, resulting in loss of antihypertensive effectiveness.Clinician should monitor patient for blood pressor response and adjust the dosage or choice of pressor accordingly.Emerphed may reduce the onset time of neuromuscular blockade when used for intubation with rocuronium if administered simultaneously with anesthetic induction.Be aware of this potential interaction. However, no information is available on the effects of the drug on the breastfed infant or the effects of the drug on milk production. Children weighing 7.5 to 15 kg—0.1 mg injected under the skin or into the muscle of your thigh.