Racemic Epinephrine

If you stopped breathing, you would die within a few minutes. Everyone has to breath, but a severe respiratory condition can make breathing impossible. To treat these conditions, doctors use medications like racemic epinephrine. This medication is typically used for small children who have problems breathing. They may suffer from symptoms like wheezing, tightness in the chest or being short of breath. Respiratory illnesses can be serious, so it is important that children get treatment.

When someone is given racemic epinephrine, it basically opens up their airways. This allows them to start breathing again and provides a temporary fix for the underlying problem.

What Is Racemic Epinephrine?

This medication is known as a bronchodilator. That means that it helps respiratory conditions that cause the lungs and respiratory system to tighten and close. This inhaled medication is made from epinephrine and a bronchodilator. These two medications are blended together to achieve a dual result. The epinephrine is a type of anti-histamine that alleviates your reaction to chemicals that normally cause an inflammation in your lungs. It basically helps to keep your airways and reduce your reaction to the inflammation. Meanwhile, the bronchodilator is responsible for opening up the airways so that you can breathe.

There are many conditions that can be treated with racemic epinephrine, but one of the most common ones is asthma. It can be used after extubation of a ventilator tube to limit the irritation. In addition, it can be used to treat the respiratory syncyctial virus (RS) as well as moderate to severe cases of croup in children.

How Does It Work?

Histamines are normally produced in response to an allergen or a trigger that causes inflammation. An anti-histamine like racemic epinephrine is used to reduce the histamines in the body and constrict your blood vessels. This allows blood to leave the lungs, and new, oxygenated blood can then reach the heart and the rest of your body. In addition, this medication helps your bronchial tubes relax so that air can actually reach your lungs again.

The Types of Racemic Epinephrine

In general, there are two main types of racemic epinephrine. You can either get this medication over the counter or with a prescription.

Over-the-Counter Options

One of the over-the-counter forms of racemic epinephrine that you will find is known as Asthmanefrin. This is known as a nebulized racemic epinephrine, so it requires a device that can turn the liquid into a breathable mist. This over-the-counter racemic epinephrine is only designed for adults, so you should not give it to your child. You should also only use it with a doctor’s supervision. When used properly, this over-the-counter drug can help protect your lungs from bronchospasms, although it is not as effective as a prescription for albuterol. Mostly, this is due to the lower milligrams available in the over-the-counter drug.


When you get a prescription for racemic epinephrine, it arrives in a ½ ml vial. This vial is then placed in your nebulizer machine. When you need it, you just have to breathe in the mist slowly. Within 30 minutes, the medication should begin to have an effect. If you are having breathing problems, you may be given a dose of this at the emergency room. Afterward, your doctor may write a prescription for it so that you can take the medication at home if you need to.

Are There Side Effects to using Racemic Epinephrine?

Like any medication, there are side effects to using racemic epinephrine. While these side effects do not occur in every case, they can occur. You may experience symptoms like a reduced appetite, tremors, dizziness or anxiety. Other symptoms include shakiness, muscle tension, nervousness, nausea, headaches or insomnia.

The previous side effects are the most common and will generally go away without a problem. If they become troublesome, you can always talk to your doctor about your other options. In severe cases, you may have worse side effects that require immediate medical care. If you experience increased blood pressure, chest pain, increased heart rate, hallucinations, disorientation, agitation or aggressive behavior, go to your doctor immediately. If you experience signs of an allergic reaction like swelling on your face, rashes, hives or breathing problems, you should also go to your doctor immediately. In severe cases, this medication can cause side effects such as strokes, cardiac arrhythmia, heart attacks and brain hemorrhaging.

How Is Racemic Epinephrine Supposed to Be Used?

You should always follow your doctor’s directions when using racemic epinephrine. In general, adults are given a 2.25 percent solution made of a 0.5ml solution and 3ml of saline. This is typically taken every three to four hours as you need it. If you get the over-the-counter prescription, the directions are the same, and you should make sure that you do not take it more often than every three hours. If you need it more often than that, go to your doctor to get immediate medical care.

Children with bronchial asthma are prescribed a 2.25 percent solution. If they are four years old or older, they will take a 0.5 ml solution diluted with 2ml of saline for 15 minutes, every three to four hours as needed. Children younger than 4 are given the same solution diluted with 3ml of saline that is administered for 15 minutes every 12 hours. With over-the-counter Asthmanefrin, children under the age of four should not take it without a doctor’s recommendation. Children over the age of four generally take the recommended amount for one to three inhales, every three to four hours. You should always check with your doctor before giving your child over-the-counter Asthmanefrin.


– If your child does not immediately respond to the medication, get medical attention immediately.
– Ask your doctor before using this medication on children younger than 12.
– Never take more than the recommended dosage.
– Do not use it if you are on an MAO inhibitor.
– Use with the correct bronchodilator.
– Extra caution should be exercised if you have blood pressure or heart problems.
– Go to your doctor immediately if the medication does not help.

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