Epinephrine is safe to use in pregnancy, either as a local anesthetic or to treat anaphylaxis.

Epinephrine is a drug that has multiple effects on the body, including increasing blood pressure and expanding the airways.

People may use epinephrine as a local anesthetic or to treat a severe allergic reaction.

This article discusses epinephrine safety during pregnancy, including for use during dental treatments and to treat anaphylaxis.

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A 2017 case report notes that epinephrine is a safe drug to use during pregnancy, with no major side effects.

According to a 2019 article, there is a theoretical risk of epinephrine causing uterine artery spasms, which may cause premature labor.

However, there is no evidence of negative side effects of epinephrine use in humans during pregnancy.

Healthcare professionals may need to use epinephrine with caution if the pregnant person’s blood pressure is 130/80 mm Hg or higher. Epinephrine may change the effects of oxytocin on the uterus, which could delay labor.

A 2019 systematic review and meta-analysis suggests that epinephrine may make the effects of local anesthetics last longer.

This could mean better pain management and health outcomes during labor without any serious side effects.

According to the American Dental Association (ADA), it is safe to use epinephrine as a local anesthetic for dental treatments during pregnancy.

Recommendations for local anesthetics for use during pregnancy include bupivacaine, lidocaine, and mepivacaine. However, some research from 2019 suggests that people should not use bupivacaine and mepivacaine during pregnancy.

According to a 2017 article, lidocaine is one of the most common local anesthetics for dental treatments and may have almost no negative side effects on the pregnant person or the fetus.

The article advises that people do not delay dental treatment due to pregnancy. However, if it is not an emergency, it may be best to receive treatment after the second trimester rather than during the first.

Although there is a theoretical risk of premature labor when using epinephrine, the benefits may outweigh the potential risks. Untreated anaphylaxis in pregnancy may be dangerous to the pregnant person and fetus.

For example, anaphylaxis may cause low blood pressure and low levels of oxygen in the blood. This may lead to a lack of oxygen reaching the fetus and the risk of severe fetal brain damage.

There is also a high risk of cesarean delivery with anaphylaxis.

According to a 2017 case report, epinephrine is a safe drug to treat anaphylaxis in pregnancy and does not cause any major side effects.

The report recommends treatment with an epinephrine auto-injector for anyone pregnant with a possible risk of anaphylaxis.

Alternative drugs suitable for treating anaphylaxis in pregnancy include:

There are limited studies and no specific guidelines on managing anaphylaxis during pregnancy. Therefore, healthcare professionals may manage the condition in the same way as in those who are not pregnant.

EpiPen

According to EpiPen, the manufacturer of an epinephrine auto-injector, there are limited studies on its use during pregnancy, and people should only use it if the potential benefit outweighs the potential risk to the fetus.

According to the Australasian Society of Clinical Immunology and Allergy (ASCIA), epinephrine is the first-line treatment of anaphylaxis in pregnancy, and quick treatment is essential.

ASCIA states that the benefits of managing a pregnant person’s blood pressure outweigh any potential risk of a brief reduction in blood flow to the uterus that epinephrine may cause.

This section answers common questions about epinephrine and pregnancy.

Is it OK to get local anesthetic while pregnant?

According to a 2019 article, local anesthetics can cross the placental barrier. This means they can reach the fetus.

However, there have been no reports of negative side effects in babies who experienced exposure to typical doses of suitable local anesthetics in the womb.

Local anesthetics safe for use during pregnancy include lidocaine and prilocaine. Bupivacaine and mepivacaine may not be suitable.

Can epinephrine cause pregnancy loss?

There is no evidence to suggest that epinephrine causes pregnancy loss.

A 2019 article suggests that there may be a theoretical risk of premature labor with epinephrine use, but there have been no reports of negative side effects in humans.

Research suggests that epinephrine is safe during pregnancy and does not cause serious side effects.

Research suggests that epinephrine is safe to use during pregnancy, both as a local anesthetic and as a treatment for anaphylaxis.

Anaphylaxis is rare in pregnancy, but without prompt treatment may be life threatening for both the pregnant person and the fetus.

Experts recommend epinephrine as a first-line treatment for anaphylaxis during pregnancy.