Drug interactions
Chlorpromazine + Epinephrine
Severity: Major
Chlorpromazine and Epinephrine: major interaction.
Last updated Sources: US FDA label
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
Chlorpromazine blocks alpha-adrenergic receptors, so epinephrine given to a treated patient can produce unopposed beta-mediated vasodilation and a paradoxical fall in blood pressure. Both agents can also be proarrhythmic, adding to cardiac risk.
What this interaction means in plain words
Chlorpromazine and Epinephrine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Chlorpromazine belongs to Central Nervous System; Epinephrine belongs to Endocrine.
Why it happens
Alpha-1 receptor blockade by chlorpromazine reverses the pressor effect of epinephrine, with additive arrhythmogenic potential.
What to do
Avoid epinephrine for treating hypotension in patients on chlorpromazine; use norepinephrine or phenylephrine instead. For anaphylaxis, epinephrine remains essential, so give it with continuous blood pressure and ECG monitoring.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Chlorpromazine
- Chlorpromazine + Dofetilide Contraindicated
- Chlorpromazine + Dronedarone Contraindicated
- Chlorpromazine + Droperidol Contraindicated
- Chlorpromazine + Ibutilide Contraindicated
- Chlorpromazine + Metrizamide Contraindicated
- Chlorpromazine + Panobinostat Contraindicated
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 Chlorpromazine with Epinephrine?
MediHelp rates the interaction as major. Chlorpromazine and Epinephrine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Chlorpromazine blocks alpha-adrenergic receptors, so epinephrine given to a treated patient can produce unopposed beta-mediated vasodilation and a paradoxical fall in blood pressure. Both agents can also be proarrhythmic, adding to cardiac risk.
How serious is the interaction between Chlorpromazine and Epinephrine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid epinephrine for treating hypotension in patients on chlorpromazine; use norepinephrine or phenylephrine instead. For anaphylaxis, epinephrine remains essential, so give it with continuous blood pressure and ECG monitoring.
What other medicines interact with Chlorpromazine?
MediHelp also lists interactions of Chlorpromazine with, for example, Dofetilide, Dronedarone, Droperidol. The full list is on the Chlorpromazine page.
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