Indications
Racepinephrine (racemic epinephrine) is an inhaled bronchodilator, a medicine that opens the airways. It is used for temporary relief of mild, occasional asthma symptoms such as wheezing, chest tightness and shortness of breath in people already diagnosed with asthma by a doctor. In hospitals it is also given by nebuliser to children with croup to reduce swelling in the upper airway. It is not a long-term controller for asthma.
How It Works
Racepinephrine is a mixture of the two mirror-image forms of Epinephrine (adrenaline). When inhaled, it stimulates receptors in the airways that relax the muscles around the breathing tubes, and it narrows small blood vessels, which reduces swelling of the airway lining. Its effect starts within minutes but lasts only a short time.
Dosage and Administration
Use only as directed on the label or by your doctor, with the inhaler or nebuliser device intended for it. Use the smallest number of inhalations that relieves symptoms and do not exceed the maximum daily number on the label. Do not use more often than directed. In croup, it is given by a doctor or nurse in a health facility, and the child is watched for a few hours afterwards.
Interactions
Do not use with MAO inhibitor antidepressants (or within 2 weeks of stopping them). Use caution with other stimulants or decongestants (such as Pseudoephedrine), caffeine, tricyclic antidepressants such as Amitriptyline, thyroid medicine, and Digoxin, as these can increase effects on the heart. Beta blockers such as Propranolol can block its effect and may raise blood pressure.
Contraindications
- Allergy to Racepinephrine or Epinephrine.
- Use within 2 weeks of an MAO inhibitor.
- Not for people who have never been diagnosed with asthma by a doctor.
- Caution or avoid with heart disease, high blood pressure, overactive thyroid, diabetes, enlarged prostate, glaucoma or seizures unless a doctor advises.
Side Effects
Common effects include nervousness, shakiness (tremor), fast heartbeat, headache, sleeplessness, nausea and a bad taste or dry throat.
Get urgent medical help if breathing does not improve within 20 minutes or gets worse, if you need it more often than usual, or if you have chest pain, a pounding or irregular heartbeat, severe headache, or swelling of the face and throat.
Pregnancy and Lactation
Asthma control is important in pregnancy, but this medicine is not the preferred reliever. Use during pregnancy or breastfeeding only if a doctor advises; inhaled Salbutamol is usually preferred.
Precautions and Warnings
Frequent need for a reliever means asthma is not well controlled: see a doctor about preventer treatment. Do not use for more than a few days without medical advice. Keep track of how many times you use it each day. Children should use it only under medical direction.
Overdose
Too much may cause severe shaking, very fast or irregular heartbeat, chest pain, high blood pressure, vomiting and agitation. Seek emergency care.
Therapeutic Class
Bronchodilator, sympathomimetic (adrenergic agonist).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Do not freeze. Do not use the solution if it turns pink or brown or contains particles.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.