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Related Experiment Video

Updated: Jun 14, 2025

Dry Powder and Nebulized Aerosol Inhalation of Pharmaceuticals Delivered to Mice Using a Nose-only Exposure System

Dry Powder and Nebulized Aerosol Inhalation of Pharmaceuticals Delivered to Mice Using a Nose-only Exposure System

Published on: April 6, 2017

Comparison of Systemic Exposure Between Epinephrine Delivered via Metered-Dose Inhalation and Intramuscular

Jack Yongfeng Zhang¹, Mary Ziping Luo¹, Tony Marrs¹

¹Amphastar Pharmaceuticals, Inc., Rancho Cucamonga, California, USA.

Journal of Aerosol Medicine and Pulmonary Drug Delivery

|August 29, 2024

Summary

This summary is machine-generated.

Primatene MIST (epinephrine metered-dose inhaler) showed significantly lower systemic drug exposure compared to epinephrine injections and albuterol inhalers. This lower exposure correlated with a safer cardiovascular profile for inhaled epinephrine in asthma patients.

Keywords:

albuterol asthma epinephrine intramuscular injection metered-dose inhaler systemic exposure

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Area of Science:

Pharmacology and Toxicology
Respiratory Medicine
Cardiovascular Safety

Background:

Concerns exist regarding the cardiovascular safety of epinephrine metered-dose inhalers (MDIs) for asthma treatment.
Previous concerns often stemmed from epinephrine's injection route, not inhalation.
Albuterol inhalers are a common asthma treatment comparator.

Purpose of the Study:

To evaluate and compare systemic drug exposure of epinephrine delivered via MDI versus intramuscular (IM) injection.
To compare systemic exposure of epinephrine MDI with albuterol MDI.
To understand the relationship between epinephrine/albuterol administration routes and cardiovascular effects.

Main Methods:

A randomized, evaluator-blinded, three-arm crossover study in 28 healthy adults.
Compared plasma levels of epinephrine and albuterol after MDI and IM administration.
Assessed safety through vital signs, ECGs, adverse events, and lab tests.

Main Results:

Systemic drug exposure for epinephrine MDI was ~9 times lower than IM epinephrine and ~122 times lower than albuterol MDI.
Epinephrine MDI showed rapid plasma drug clearance, unlike IM epinephrine or albuterol MDI.
Epinephrine MDI and albuterol MDI had minimal cardiovascular effects; IM epinephrine caused transient increases in blood pressure and heart rate.

Conclusions:

Epinephrine MDI (Primatene MIST) demonstrates significantly lower systemic drug exposure compared to IM epinephrine and albuterol MDI.
The reduced systemic exposure of inhaled epinephrine is associated with a favorable safety profile, lacking significant cardiovascular adverse effects.
Findings support the safety of epinephrine MDI for asthma treatment, particularly concerning cardiovascular effects compared to other administration routes.