March 9, 2006
Epinephrine tablet promising for anaphylaxis
By Megan Rauscher
NEW YORK (Reuters Health) - It may be possible to
administer epinephrine in a tablet -- placed under the tongue
-- for the emergency treatment of anaphylaxis, a severe and
sometimes fatal allergic reaction, according to research
presented this week during the annual meeting of the American
Academy of Allergy, Asthma and Immunology in Miami Beach.
Dr. Keith J. Simons from the University of Manitoba in
Winnipeg and colleagues tested this approach in rabbits, which
were given a new, rapidly disintegrating tablet containing
epinephrine placed under the tongue. "This is similar to the
approach used for the administration of nitroglycerin for the
treatment of angina (chest pain)," Simons noted.
The oral treatment resulted in blood levels of epinephrine
similar to those achieved with 0.3 mg epinephrine administered
intramuscularly in the thigh -- the currently recommended
emergency treatment for anaphylaxis.
Tablets containing increasing doses of epinephrine were
retained under the tongue for 5 minutes and the EpiPen was
injected in the thigh. Blood was collected before dosing and at
various times afterwards up to 180 minutes.
The maximum blood concentrations and time to maximum blood
concentrations were similar when epinephrine was given under
the tongue or by EpiPen injection.
"If this approach is successful," Simons told Reuters
Health, "patients experiencing anaphylaxis in the community
could slip a tablet under the tongue instead of self-injecting
a dose of epinephrine into the thigh muscle."
"This tablet formulation now needs to be tested in humans,"
he added, noting that "it may provide a non-invasive method for
the emergency treatment of anaphylaxis."