Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Twinject (Epinephrine). If you are concerned about side effects, discuss the risks and benefits of Twinject (Epinephrine) with your doctor.

The following side effects have been reported by at least 1% of people taking Twinject (Epinephrine). Many of these side effects can be managed, and some may go away on their own over time.

• anxiety
• dizziness
• fear
• headache
• nausea
• paleness
• restlessness
• shakiness
• sweating
• tenseness
• throbbing
• tremors
• vomiting
• weakness

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

• chest pain
• difficulty breathing
• increased heart rate or pounding heartbeat
• irregular heartbeat
• symptoms of a Stroke (e.g., sudden blurred vision, difficulty speaking, dizziness, headache, weakness)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Twinject (Epinephrine).

Twinject (Epinephrine) should not be used by anyone who is allergic to Twinject (Epinephrine) or to any of the ingredients of the medication.

There may be an interaction between Twinject (Epinephrine) and any of the following:

• alpha blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• Atomoxetine
• beta-blockers (e.g., Propranolol, Atenolol, Metoprolol)
• Bromocriptine
• Cabergoline
• certain antihistamines (e.g., Diphenhydramine, tripelennamine, Chlorpheniramine)
• caffeine
• cannabis
• cocaine
• decongestant cold medications (e.g., phenylephrine, Pseudoephedrine)
• decongestant eye drops and nose sprays (e.g., naphazoline, oxymetazoline, xylometazoline)
• diabetes medications (e.g., chlorpropamide, glipizide, Glyburide, insulin, Metformin, Nateglinide, Rosiglitazone)
• digoxin
• dipivefrin
• diuretics (water pills; e.g., Hydrochlorothiazide, Indapamide, Furosemide)
• ergot alkaloids (e.g., ergotamine, ergonovine)
• fast-acting bronchodilators (e.g., salbutamol, terbutaline)
• hyaluronidase
• Levothyroxine
• Linezolid
• long-acting bronchodilators (e.g., formoterol, salmeterol)
• medications used to treat an abnormal heart rhythm (e.g., amiodarone, sotalol, quinidine, procainamide)
• Methylphenidate
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• Nabilone
• norepinephrine
• phenothiazines (e.g., Chlorpromazine, Perphenazine, Prochlorperazine)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• Spironolactone
• theophyllines (e.g., Aminophylline, Oxtriphylline, Theophylline)
• tricyclic antidepressants (e.g., Amitriptyline, Desipramine, Nortriptyline)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Twinject (Epinephrine). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Twinject (Epinephrine).

Accidental injection: If Twinject (Epinephrine) is accidentally injected into areas such as the hands or feet, go to the nearest emergency room for treatment. Twinject (Epinephrine) should only be injected into the thigh.

Asthma: People who have asthma may experience difficulty breathing after using Twinject (Epinephrine). If you have asthma, ensure that you inform any emergency professionals that you have asthma and have used Twinject (Epinephrine). Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Twinject (Epinephrine), and whether any special monitoring is needed.

Diabetes: People with diabetes may experience a temporary increase in blood glucose level after using Twinject (Epinephrine). If you have diabetes, discuss with your doctor how Twinject (Epinephrine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Twinject (Epinephrine), and whether any special monitoring is needed. Be sure to tell any emergency professionals that you have diabetes and that you have used Twinject (Epinephrine).

Glaucoma: The symptoms of glaucoma can be made worse when Twinject (Epinephrine) is used. If you have glaucoma, discuss with your doctor how Twinject (Epinephrine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Twinject (Epinephrine), and whether any special monitoring is needed.

Heart disease: Twinject (Epinephrine) has many effects throughout the body. It narrows the blood vessels, which in turn can increase blood pressure, heart rate and possibly cause irregular heartbeat. If you have heart disease, including high blood pressure, abnormal heartbeat or are taking medications that increase the risk of an irregular heartbeat (e.g., Digoxin, Amiodarone, Sotalol, procainamide), or have an overactive Thyroid, these conditions can be made worse for a short period of time, by using Twinject (Epinephrine). Discuss with your doctor how Twinject (Epinephrine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Twinject (Epinephrine) and whether any special monitoring is needed.

Be sure to tell any emergency professionals if you have any of these conditions and that you have used Twinject (Epinephrine).

Medical attention: Since the signs and symptoms of an allergic reaction may return after using Twinject (Epinephrine), it is important to get immediate medical attention after using it. You should be close to a hospital or emergency medical help for at least 24 hours after the start of your allergic reaction.

Parkinson's Disease (PD): People with PD may experience temporarily worsened symptoms of PD after using Twinject (Epinephrine).

Pregnancy: Twinject (Epinephrine) should only be used during pregnancy if the benefits outweigh the risks.