Table of ContentsView AllTable of ContentsFunctionsMedical UsesToo Little of EachToo Much of EachFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Functions
Medical Uses
Too Little of Each
Too Much of Each
Frequently Asked Questions
Epinephrineandnorepinephrineare chemicals naturally made in the body that help turn on ourfight-or-flight responseto stress. They function as both hormones and neurotransmitters. Having too little or too much of either can have different effects on your health.
Both epinephrine and norepinephrine are also available as medications to use in emergency situations, such as with certain types of shock or at times of critically low blood pressure. They both work on the alpha and beta receptors. However, they have slightly different functions and uses in the body.
This article will discuss the similarities and differences between norepinephrine and epinephrine, including their functions, medical uses, and effects on overall health.
Getty Images / AndreyPopov
Norepinephrine vs. Epinephrine: How Do They Function?
Asneurotransmitters, they are chemical messengers sending signals between nerve cells to activate theautonomic nervous system.The autonomic nervous system is responsible for controlling certain systems in the body, such as heart rate, breathing, and digestion.
Epinephrine
While both norepinephrine and epinephrine can activate alpha and beta receptors, epinephrine has a stronger effect on beta receptors.The beta receptors are located in the heart, lungs, and skeletal muscle.
Norepinephrine
In contrast, norepinephrine has a more dominant effect on alpha receptors primarily located only in the arteries.While norepinephrine is always present in our blood in small amounts, during stressful situations, theadrenal medullareleases more of it.
The constant, steady release of norepinephrine helps maintain blood pressure. However, during times of stress, the adrenal medulla releases more, which raises blood pressure further.
Norepinephrine stimulates the alpha receptors in the arteries. When alpha receptors are activated, the arteries constrict, or squeeze, the blood vessels, leading to an increase in blood pressure.
What Are the Medical Uses of Norepinephrine and Epinephrine?
Even though norepinephrine and epinephrine are naturally made in the body, these two chemicals can act as medications when needed in emergency situations.
Levophed (norepinephrine) is a first-line treatment that can raise blood pressure when experiencing severely low blood pressure or shock.This is because of its dominant effect on activating the alpha receptors in the arteries, which helps restore blood flow and blood pressure.
Common uses of Levophed include:
Compared with norepinephrine, epinephrine has a greater effect on activating beta receptors at low doses. Activation of beta receptors can open up airways, increase heart rate, and widen blood vessels.
Epinephrine is a lifesaving medication used in the following critical situations:
What Happens With Too Little Norepinephrine or Epinephrine In Your Body?
Certain factors can lower your norepinephrine and epinephrine levels. Low levels of norepinephrine or epinephrine can affect your physical and mental state.
Low Norepinephrine Levels
Low levels of norepinephrine can cause:
Common symptoms of this disease include:
Norepinephrine in the brain can help aid in focus and organization. Therefore, the lack of norepinephrine can result in the development ofattention deficit hyperactivity disorder(ADHD).
Low Epinephrine Levels
Having too little epinephrine in the body is rare.
One disease that can lower the levels of epinephrine isAddison’s disease. Addison’s disease suppresses the adrenal gland, which normally produces hormones such as cortisol, aldosterone, and epinephrine. Common side effects of Addison’s disease include:
What Happens With Too Much Norepinephrine and Epinephrine?
While epinephrine and norepinephrine can help you in intense situations, too much can put your mind and body on edge.
Certain factors may increase levels of norepinephrine and epinephrine, such as:
High Norepinephrine Levels
Symptoms of high levels of norepinephrine can include:
High Epinephrine Levels
Symptoms of high levels of epinephrine include:
WarningExcessive doses of epinephrine and norepinephrine can increase the risk of heart attack, stroke, or death.In this scenario, contact 911 and seek emergency medical help as soon as possible.
Warning
Excessive doses of epinephrine and norepinephrine can increase the risk of heart attack, stroke, or death.In this scenario, contact 911 and seek emergency medical help as soon as possible.
Summary
Epinephrine and norepinephrine are naturally made hormones and neurotransmitters that regulate the autonomic nervous system. Both can also be used as medications for life-threatening situations such as shock or critically low blood pressure.
The main difference between norepinephrine and epinephrine is the receptors they activate.
Norepinephrine and epinephrine can activate both alpha and beta receptors. However, norepinephrine is better at activating the alpha receptors in the arteries, making it ideal for increasing blood pressure. Epinephrine, on the other hand, has a greater effect on the beta receptors, which are located in the heart, lungs, and skeletal muscle.
Although they are slightly different, both chemicals play essential roles in the body and are used for similar purposes.
Norepinephrine and epinephrine can be used together only if norepinephrine fails to increase blood pressure in septic shock.Norepinephrine is the first-line medication in people who are in shock. If norepinephrine alone cannot bring the blood pressure back to normal, epinephrine can be added to help stabilize blood pressure.
Norepinephrine and epinephrine can be used together only if norepinephrine fails to increase blood pressure in septic shock.
Norepinephrine is the first-line medication in people who are in shock. If norepinephrine alone cannot bring the blood pressure back to normal, epinephrine can be added to help stabilize blood pressure.
Epinephrine is better at treating an anaphylactic reaction because it has a greater effect in activating beta receptors. Activation of beta receptors increases heart rate to provide more blood flow to vital organs and opens up airways to allow easier breathing.
The author would like to recognize and thank Alexya Rosas for contributing to this article.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DailyMed.Label: Levophed- norepinephrine bitartrate injection, solution, concentrate.DailyMed.Label: Adrenalin- epinephrine injection.Endocrine Society.Adrenal hormones.Motiejunaite J, Amar L, Vidal-Petiot E.Adrenergic receptors and cardiovascular effects of catecholamines.Ann Endocrinol (Paris). 2021;82(3-4):193-197. doi:10.1016/j.ando.2020.03.012Evans L, Rhodes A, Alhazzani W, et al.Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021.Intensive Care Med. 2021;47(11):1181-1247. doi:10.1007/s00134-021-06506-yVelez JCQ.Hepatorenal syndrome type 1: from diagnosis ascertainment to goal-oriented pharmacologic therapy.Kidney360. 2021;3(2):382-395. Published 2021 Dec 3. doi:10.34067/KID.0006722021Wassenberg T, Deinum J, van Ittersum FJ, et al.Clinical presentation and long-term follow-up of dopamine beta hydroxylase deficiency.J Inherit Metab Dis. 2021;44(3):554-565. doi:10.1002/jimd.12321Ranjbar-Slamloo Y, Fazlali Z.Dopamine and noradrenaline in the brain; overlapping or dissociate functions?Front Mol Neurosci. 2020;12:334. doi:10.3389/fnmol.2019.00334MedlinePlus.Dopamine beta-hydroxylase deficiency.Del Campo N, Chamberlain SR, Sahakian BJ, Robbins TW.The roles of dopamine and noradrenaline in the pathophysiology and treatment of attention-deficit/hyperactivity disorder.Biol Psychiatry. 2011;69(12):e145-157. doi:10.1016/j.biopsych.2011.02.036National Adrenal Diseases Foundation.Primary adrenal insufficiency (Addison’s disease).Shahbaz A, Aziz K, Fransawy Alkomos M, et al.Pheochromocytoma secreting large quantities of both epinephrine and norepinephrine presenting with episodes of hypotension and severe electrolyte imbalance.Cureus. 2018;10(7):e3050. doi:10.7759/cureus.3050
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DailyMed.Label: Levophed- norepinephrine bitartrate injection, solution, concentrate.DailyMed.Label: Adrenalin- epinephrine injection.Endocrine Society.Adrenal hormones.Motiejunaite J, Amar L, Vidal-Petiot E.Adrenergic receptors and cardiovascular effects of catecholamines.Ann Endocrinol (Paris). 2021;82(3-4):193-197. doi:10.1016/j.ando.2020.03.012Evans L, Rhodes A, Alhazzani W, et al.Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021.Intensive Care Med. 2021;47(11):1181-1247. doi:10.1007/s00134-021-06506-yVelez JCQ.Hepatorenal syndrome type 1: from diagnosis ascertainment to goal-oriented pharmacologic therapy.Kidney360. 2021;3(2):382-395. Published 2021 Dec 3. doi:10.34067/KID.0006722021Wassenberg T, Deinum J, van Ittersum FJ, et al.Clinical presentation and long-term follow-up of dopamine beta hydroxylase deficiency.J Inherit Metab Dis. 2021;44(3):554-565. doi:10.1002/jimd.12321Ranjbar-Slamloo Y, Fazlali Z.Dopamine and noradrenaline in the brain; overlapping or dissociate functions?Front Mol Neurosci. 2020;12:334. doi:10.3389/fnmol.2019.00334MedlinePlus.Dopamine beta-hydroxylase deficiency.Del Campo N, Chamberlain SR, Sahakian BJ, Robbins TW.The roles of dopamine and noradrenaline in the pathophysiology and treatment of attention-deficit/hyperactivity disorder.Biol Psychiatry. 2011;69(12):e145-157. doi:10.1016/j.biopsych.2011.02.036National Adrenal Diseases Foundation.Primary adrenal insufficiency (Addison’s disease).Shahbaz A, Aziz K, Fransawy Alkomos M, et al.Pheochromocytoma secreting large quantities of both epinephrine and norepinephrine presenting with episodes of hypotension and severe electrolyte imbalance.Cureus. 2018;10(7):e3050. doi:10.7759/cureus.3050
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
DailyMed.Label: Levophed- norepinephrine bitartrate injection, solution, concentrate.DailyMed.Label: Adrenalin- epinephrine injection.Endocrine Society.Adrenal hormones.Motiejunaite J, Amar L, Vidal-Petiot E.Adrenergic receptors and cardiovascular effects of catecholamines.Ann Endocrinol (Paris). 2021;82(3-4):193-197. doi:10.1016/j.ando.2020.03.012Evans L, Rhodes A, Alhazzani W, et al.Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021.Intensive Care Med. 2021;47(11):1181-1247. doi:10.1007/s00134-021-06506-yVelez JCQ.Hepatorenal syndrome type 1: from diagnosis ascertainment to goal-oriented pharmacologic therapy.Kidney360. 2021;3(2):382-395. Published 2021 Dec 3. doi:10.34067/KID.0006722021Wassenberg T, Deinum J, van Ittersum FJ, et al.Clinical presentation and long-term follow-up of dopamine beta hydroxylase deficiency.J Inherit Metab Dis. 2021;44(3):554-565. doi:10.1002/jimd.12321Ranjbar-Slamloo Y, Fazlali Z.Dopamine and noradrenaline in the brain; overlapping or dissociate functions?Front Mol Neurosci. 2020;12:334. doi:10.3389/fnmol.2019.00334MedlinePlus.Dopamine beta-hydroxylase deficiency.Del Campo N, Chamberlain SR, Sahakian BJ, Robbins TW.The roles of dopamine and noradrenaline in the pathophysiology and treatment of attention-deficit/hyperactivity disorder.Biol Psychiatry. 2011;69(12):e145-157. doi:10.1016/j.biopsych.2011.02.036National Adrenal Diseases Foundation.Primary adrenal insufficiency (Addison’s disease).Shahbaz A, Aziz K, Fransawy Alkomos M, et al.Pheochromocytoma secreting large quantities of both epinephrine and norepinephrine presenting with episodes of hypotension and severe electrolyte imbalance.Cureus. 2018;10(7):e3050. doi:10.7759/cureus.3050
DailyMed.Label: Levophed- norepinephrine bitartrate injection, solution, concentrate.
DailyMed.Label: Adrenalin- epinephrine injection.
Endocrine Society.Adrenal hormones.
Motiejunaite J, Amar L, Vidal-Petiot E.Adrenergic receptors and cardiovascular effects of catecholamines.Ann Endocrinol (Paris). 2021;82(3-4):193-197. doi:10.1016/j.ando.2020.03.012
Evans L, Rhodes A, Alhazzani W, et al.Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021.Intensive Care Med. 2021;47(11):1181-1247. doi:10.1007/s00134-021-06506-y
Velez JCQ.Hepatorenal syndrome type 1: from diagnosis ascertainment to goal-oriented pharmacologic therapy.Kidney360. 2021;3(2):382-395. Published 2021 Dec 3. doi:10.34067/KID.0006722021
Wassenberg T, Deinum J, van Ittersum FJ, et al.Clinical presentation and long-term follow-up of dopamine beta hydroxylase deficiency.J Inherit Metab Dis. 2021;44(3):554-565. doi:10.1002/jimd.12321
Ranjbar-Slamloo Y, Fazlali Z.Dopamine and noradrenaline in the brain; overlapping or dissociate functions?Front Mol Neurosci. 2020;12:334. doi:10.3389/fnmol.2019.00334
MedlinePlus.Dopamine beta-hydroxylase deficiency.
Del Campo N, Chamberlain SR, Sahakian BJ, Robbins TW.The roles of dopamine and noradrenaline in the pathophysiology and treatment of attention-deficit/hyperactivity disorder.Biol Psychiatry. 2011;69(12):e145-157. doi:10.1016/j.biopsych.2011.02.036
National Adrenal Diseases Foundation.Primary adrenal insufficiency (Addison’s disease).
Shahbaz A, Aziz K, Fransawy Alkomos M, et al.Pheochromocytoma secreting large quantities of both epinephrine and norepinephrine presenting with episodes of hypotension and severe electrolyte imbalance.Cureus. 2018;10(7):e3050. doi:10.7759/cureus.3050
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