Can You Be Allergic to Epinephrine?

Some people may experience side effects to a life-saving medication called epinephrine. However, it is unlikely that you can be "allergic" to epinephrine. Epinephrine use in the case of allergic reaction affecting the airway has and will continue to save many lives. There is no absolute contraindication to using epinephrine in suspected cases of acute anaphylaxis.

Epinephrine Injection
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What Is Epinephrine?

Another name for epinephrine is adrenaline and it is a hormone that is produced by your adrenal glands. You can't live without it. This is why it seems odd that rarely an individual can experience an allergic reaction when given epinephrine as a medication.

Epinephrine is released from your adrenal glands in response to stress and is responsible for the "fight or flight" phenomenon. It has several effects on the body including making your heart rate faster and boosting the oxygen and nutrient supply to your skeletal muscles and your brain so that you can run away from danger. It also increases your awareness and gives you sharper vision and hearing.

Epinephrine is released in response to fear or stress in small bursts and these effects typically last a very short amount of time, just long enough to allow us to survive stressful or dangerous situations.

People who do not produce enough epinephrine from their adrenal glands have a condition called Addison's disease which can be fatal if not treated properly.

How Epinephrine Is Used to Treat an Allergic Reaction

Epinephrine is used as a medication for life-threatening allergic reactions (anaphylaxis) and can save your life. Epinephrine is often prescribed to individuals at risk of a severe allergic reaction as an auto-injector which can be given as a shot into the muscle at the first sign of anaphylaxis. Epinephrine is the drug of choice and the first drug that should be administered in acute anaphylaxis. Epinephrine reverses immediate, life threatening symptoms such as difficulty breathing, wheezing, and swelling affecting the respiratory system. For this reason, there is no medical contraindication to the use of epinephrine in the case of allergic reaction causing acute anaphylaxis.

Allergic Reaction to Epinephrine

Epinephrine is a hormone that is naturally produced by the body, and essential to life. In most cases, a true allergy to epinephrine doesn't exist. The component of our immune system that causes respiratory-system swelling is tuned to react to foreign allergens. Because epinephrine is naturally present in your body, a minor, additional injected amount of epinephrine is unlikely to cause allergic reaction.

That is not to say that people haven't experienced side effects due to epinephrine including: breathing problems, faster heart rate, sweating, nausea, dizziness, anxiety, and fear. These changes are not immediately life-threatening, and are signs that injected epinephrine is working in the body as intended: that is to reverse a potentially life threatening allergic reaction. These side effects of epinephrine are minor compared to death, the worst outcome of an allergic reaction that is threatening to block an airway (acute anaphylaxis).

Often these effects are due to the allergic reaction and not epinephrine, or are the natural effects of adrenaline on the body. As we react to different sources of stress differently, the affects of adrenaline will affect different people differently.

You may also be allergic to a combination medication. For example, epinephrine is commonly combined with another drug called lidocaine and there have been some reports of allergic reactions to this combination. Lidocaine is a local anesthetic used to treat pain and the combination of lidocaine and epinephrine is sometimes used in dentist offices.

Before Using Epinephrine

There is no medical reason to not use epinephrine if you have sudden difficulty breathing, wheezing, or swelling near your respiratory system. Do not hesitate to use epinephrine if you have these symptoms. Allergic reaction near the airway will cause death by suffocation.If you have had a negative reaction to epinephrine, you must visit a healthcare provider. In fact, you should consult a healthcare provider if you have ever needed to use an epipen. You may need the help of a specialized doctor called an immunologist. You may need to research any preservatives, additives or combination medications that may have been in the epinephrine you were given and be tested for an allergy to each one of these individual substances.

It should be noted that if you have a history of anaphylaxis, your healthcare provider may instruct you to use epinephrine regardless of a confirmed allergy to it or a previous negative reaction. That's because anaphylaxis is so life-threatening that the benefits may outweigh the risks.

You may want to look at options such as immunotherapy (allergy shots) to treat your condition. It will be important for you to be extra vigilant about avoiding any potential substance which may trigger an anaphylactic episode. You also will need to know how to recognize the first signs and symptoms of an anaphylactic reaction so that you can initiate treatment immediately.

Always call 911 even if you have your own epinephrine and have administered it. The allergen that you are reacting to may be present in your system for longer than your dose of epinephrine will last.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Merck Manual Professional Version. Addison Disease.

  3. U.S. National Library of Medicine. Epinephrine Injection.

  4. Kim H, Lee JM, Seo KS, Kwon SM, Row HS. Anaphylactic reaction after local lidocaine infiltration for retraction of retained teethJ Dent Anesth Pain Med. 2019;19(3):175–180. doi:10.17245/jdapm.2019.19.3.175

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.