Epinephrine, also known as adrenaline, is a type of hormone and medication that a person may use in emergencies, such as treating life threatening allergic reactions. However, in some cases, a doctor may prescribe it for asthma.
Asthma is a condition that affects the lungs and can make breathing more difficult. Doctors often use various medications, such as inhalers, to help with immediate symptoms and attacks. Other options can also help prevent attacks from occurring.
In emergency situations where a person’s symptoms do not respond to other asthma medications, a doctor may recommend the use of epinephrine.
This article reviews how and when a doctor may use epinephrine for asthma, how it works, its administration, and other asthma treatments.
According to the Asthma and Allergy Foundation of America (AAFA), emergency rooms used to use injectable epinephrine in cases where other asthma medications did not help improve a person’s symptoms.
The AAFA goes on to note that the advent and availability of a wider range of fast-acting asthma medications makes the practice of using epinephrine less common. As a result, a doctor may use epinephrine for extreme cases and under supervision in an emergency room setting.
As a 2022 study notes, international guidelines recommend not using intramuscular epinephrine for acute asthma except for cases where the person also has anaphylaxis, angioedema, or if they are away from a medical facility when life threatening symptoms occur.
Epinephrine comes in inhaled forms as well as the injectable form. Experts indicate that inhaled epinephrine from a nebulizer or handheld device may help to manage asthma symptoms, but they also note that many guidelines only recommend it for use in children with croup. This is partly due to low quality evidence for using inhaled forms of epinephrine for practices such as asthma relief.
Epinephrine is a synthetic version of the naturally occurring hormone adrenaline. The adrenal gland produces it as part of the fight-or-flight response.
It affects several parts of the body in different ways, including:
- increasing blood flow to muscles
- dilating the eyes
- making the heart pump faster and harder
- helping a person breathe deeper and faster
Epinephrine is able to encourage easier breathing as it interacts with beta receptors present in lung tissue. This helps the muscles relax, which allows the bronchioles to dilate. As such, this allows a person to breathe easier. After receiving an injection of epinephrine, in addition to breathing easier, a person will likely experience other effects, such as a faster heartbeat.
Epinephrine comes in two forms that a doctor may, in some situations, recommend for use in asthma. They include an injection and inhaled forms.
A doctor may recommend using the injected form in certain circumstances, including:
- as a secondary or last-resort option in a hospital if other medications are not working
- when a person experiences potentially life threatening asthma symptoms and has access to an EpiPen
- for people who also may experience anaphylaxis
A person can administer injectable epinephrine by:
- Holding their leg firmly in place while performing the injection.
- Placing the tip of the injectable against the upper leg at a right angle.
- Swinging and pushing the auto-injector firmly until it makes a “click” sound.
- Holding firmly in place for 3 seconds.
- Removing the auto-injector from the thigh.
- Massaging the injection area for 10 seconds.
A person can also inhale epinephrine for asthma. However, due to a lack of quality evidence supporting its use, a doctor will likely recommend other regular treatments for asthma over inhaled epinephrine.
Treatment for asthma focuses on reducing symptom severity, preventing attacks, and generally improving quality of life. Medications for asthma typically come in fast-acting or rapid relief or long-term forms. Medications a doctor may recommend
- short-acting beta2-agonists
- short-acting anticholinergics
- oral corticosteroids
- inhaled mast cell stabilizers
- inhaled corticosteroids
- leukotriene modifiers
- inhaled long-acting bronchodilators
- allergy shots
Medications generally help reduce inflammation or swelling and clear the airways to make breathing easier. Some medications, such as allergy shots, can help reduce triggering events from allergies.
A doctor may also help a person develop an asthma action plan. This plan can include how and when to take medications, what to do when an attack occurs, and how to handle different situations that may trigger an attack. For example, a person may need to use an inhaler before playing a sport or exercise to help prevent an exercise-induced attack.
If a person is at risk of anaphylaxis, a doctor may prescribe injectable epinephrine. A person should carry this with them at all times to provide emergency relief if they have difficulty breathing due to an allergic reaction or severe asthma attack.
Epinephrine is a synthetic version of the naturally occurring hormone adrenaline. It has many potential uses in medical emergencies. It is not generally a first-line treatment or recommended for regular use in asthma but it may help in emergencies.
A doctor has several options to help treat a person’s asthma. They include medications for long-term use as well as fast-acting medications in the case of an asthma attack.