Drug interactions
Bretylium + Epinephrine
Severity: Moderate
Bretylium and Epinephrine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Bretylium initially releases norepinephrine and then blocks neuronal reuptake and release, which can augment the pressor and arrhythmogenic effects of catecholamines. Combined use may cause marked hypertension and arrhythmias.
What this interaction means in plain words
Bretylium and Epinephrine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Bretylium inhibits neuronal catecholamine reuptake and causes adrenergic nerve terminal release, sensitizing receptors to exogenous catecholamines.
What to do
If a vasopressor is needed, use a dilute solution at a low starting dose and monitor blood pressure and ECG continuously.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Epinephrine
- Epinephrine + Isocarboxazid Contraindicated
- Epinephrine + Phenelzine Contraindicated
- Epinephrine + Tranylcypromine Contraindicated
- Acebutolol + Epinephrine Major
- Amitriptyline + Epinephrine Major
- Amoxapine + Epinephrine Major
Frequently asked questions
Can I take Bretylium with Epinephrine?
MediHelp rates the interaction as moderate. Bretylium and Epinephrine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Bretylium initially releases norepinephrine and then blocks neuronal reuptake and release, which can augment the pressor and arrhythmogenic effects of catecholamines. Combined use may cause marked hypertension and arrhythmias.
How serious is the interaction between Bretylium and Epinephrine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: If a vasopressor is needed, use a dilute solution at a low starting dose and monitor blood pressure and ECG continuously.
What other medicines interact with Epinephrine?
MediHelp also lists interactions of Epinephrine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Epinephrine page.
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