Efficacy of nebulized L-epinephrine for treatment of croup: a randomized, double-blind study

Fundam Clin Pharmacol. 2016 Feb;30(1):70-5. doi: 10.1111/fcp.12158. Epub 2015 Nov 12.


The objective of this study was to compare the effect of L-epinephrine plus dexamethasone vs. dexamethasone for treatment of croup in children. A randomized, double-blind clinical trial was implemented on 174 patients with croup, aged from 6 months to 6 years, and admitted to the Amir Kabir Pediatric Hospital (Arak, Iran). After randomized allocation, patients were administered dexamethasone, and then, they received either saline or L-epinephrine. Westley croup scores, heart rate, respiratory rate, and blood pressure were recorded every half an hour for a total of 120 min. There was a significant difference in mean of croup scores between two groups (P < 0.009). In addition, a significant difference was seen on mean of heart rate between two groups (P < 0.026). Our results showed a considerable difference in reduction of velocity of croup scores in patients who received nebulized L-epinephrine compared to patients who received placebo.

Keywords: L-epinephrine; Westley croup score; children; croup.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adrenergic beta-Agonists / administration & dosage
  • Adrenergic beta-Agonists / therapeutic use*
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / therapeutic use
  • Blood Pressure / drug effects
  • Child
  • Child, Preschool
  • Croup / drug therapy*
  • Croup / metabolism
  • Croup / physiopathology
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use
  • Double-Blind Method
  • Drug Therapy, Combination
  • Epinephrine / administration & dosage
  • Epinephrine / therapeutic use*
  • Female
  • Heart Rate / drug effects
  • Humans
  • Infant
  • Injections, Intramuscular
  • Male
  • Nebulizers and Vaporizers
  • Respiratory Rate / drug effects
  • Severity of Illness Index


  • Adrenergic beta-Agonists
  • Anti-Inflammatory Agents
  • Dexamethasone
  • Epinephrine

Associated data

  • IRCT/20110515649N1