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What Is Racemic Epinephrine?

By C.B. Fox
Updated Jan 27, 2024
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Racemic epinephrine is a synthetic form of adrenaline that is primarily used to ease respiratory distress. It can be safely used in both children and adults and can significantly reduce the risk of a patient losing consciousness or dying because of a constriction of the airways. Like other forms of epinephrine, racemic epinephrine works quickly to trigger the body's natural fight-or-flight response. The effects of the drug wear off quickly and multiple doses may be needed.

Two types of epinephrine are present in racemic epinephrine. The active part of the compound is known as levorotary epinephrine and has the same chemical formula as the inactive ingredient, dextrorotary epinephrine. Levorotary and dextrorotary molecules are mirror images of one another. Racemic describes a compound composed of a mixture of these forms.

When it is administered, racemic epinephrine works quickly to reduce the effects of a severe histamine reaction. It stimulates the alpha adrenergic receptors, which makes the blood vessels in the lungs constrict. This reduces the hydrostatic pressure of the lungs, which allows the blood to flow more easily into and out of the lungs, carrying oxygen back to the heart to replenish the supply in the rest of the body. The drug also affects the beta adrenergic receptors, allowing the bronchial tubes to relax and widen, allowing more air to move through the lungs.

Patients may be administered racemic epinephrine for a number of different reasons. It is commonly used in the treatment of bronchiolitis, severe asthma, or croup syndrome. In each of these conditions, a patient is generally brought into the emergency room in severe respiratory distress, either conscious or unconscious. Administering this substance can quickly reverse the symptoms of constricted breathing passageways, allowing the patient to begin to breathe normally within a few minutes.

Racemic epinephrine is considered safe for both children and adults. There are a number of side effects associated with the use of the drug, including increased heart rate and a panicky feeling, though there are rarely any severe complications from its use. Patients are given this drug under the observation of a medical team so that a patient who has a severe adverse reaction can be treated promptly. In most cases, the effects of racemic epinephrine wear off within a couple of hours, and it may need to be administered again if the patient has not improved significantly.

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