Drug interactions
Carbidopa-entacapone-levodopa + Epinephrine
Severity: Moderate
Carbidopa-entacapone-levodopa 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
Entacapone inhibits COMT, a major route of epinephrine inactivation, so systemic epinephrine effects may be enhanced and prolonged. This can lead to marked tachycardia, arrhythmias and hypertension.
What this interaction means in plain words
Carbidopa-entacapone-levodopa 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.
Carbidopa-entacapone-levodopa belongs to Central Nervous System; Epinephrine belongs to Endocrine.
Why it happens
COMT inhibition by entacapone reduces methylation and clearance of epinephrine.
What to do
Use the lowest effective epinephrine dose and monitor heart rate, rhythm and blood pressure. Do not delay epinephrine in anaphylaxis or cardiac arrest.
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 Carbidopa-entacapone-levodopa
- Carbidopa-entacapone-levodopa + Isocarboxazid Contraindicated
- Carbidopa-entacapone-levodopa + Phenelzine Contraindicated
- Carbidopa-entacapone-levodopa + Selegiline transdermal Contraindicated
- Carbidopa-entacapone-levodopa + Tranylcypromine Contraindicated
- Amisulpride + Carbidopa-entacapone-levodopa Major
- Asenapine transdermal + Carbidopa-entacapone-levodopa Major
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 Carbidopa-entacapone-levodopa with Epinephrine?
MediHelp rates the interaction as moderate. Carbidopa-entacapone-levodopa 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. Entacapone inhibits COMT, a major route of epinephrine inactivation, so systemic epinephrine effects may be enhanced and prolonged. This can lead to marked tachycardia, arrhythmias and hypertension.
How serious is the interaction between Carbidopa-entacapone-levodopa 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: Use the lowest effective epinephrine dose and monitor heart rate, rhythm and blood pressure. Do not delay epinephrine in anaphylaxis or cardiac arrest.
What other medicines interact with Carbidopa-entacapone-levodopa?
MediHelp also lists interactions of Carbidopa-entacapone-levodopa with, for example, Isocarboxazid, Phenelzine, Selegiline transdermal. The full list is on the Carbidopa-entacapone-levodopa page.
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