From the Research
Phentolamine is the most effective reversal agent for epinephrine, particularly in cases of digital or glanular ischemia, as evidenced by the most recent study 1. Epinephrine (adrenaline) is a naturally occurring catecholamine that acts on alpha and beta adrenergic receptors, and its effects typically resolve quickly due to its short half-life of approximately 2-3 minutes. When adverse effects occur, such as tachycardia, hypertension, anxiety, or tremors, management focuses on supportive care while allowing the medication to metabolize naturally. For severe hypertension, short-acting antihypertensives like phentolamine (5-10 mg IV) or labetalol (10-20 mg IV) may be used to counteract alpha-adrenergic effects, as seen in studies 2 and 3. Some key points to consider when managing epinephrine overdose or adverse effects include:
- Close monitoring of vital signs
- Providing supportive care
- Targeted symptom management while the drug naturally clears from the system
- The use of phentolamine as a reversal agent in specific cases, such as digital or glanular ischemia, as supported by the most recent and highest quality study 1. It is essential to note that the best approach may vary depending on the specific context and the patient's condition, and the use of phentolamine as a reversal agent should be guided by the most recent and highest quality evidence, such as the study published in 2025 1.