Drug interactions
Cocaine + Epinephrine
Severity: Major
Cocaine 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
Cocaine blocks catecholamine reuptake, potentiating epinephrine's sympathomimetic effects. This raises the risk of hypertension, myocardial ischemia and ventricular arrhythmias.
What this interaction means in plain words
Cocaine 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.
Cocaine belongs to Central Nervous System; Epinephrine belongs to Endocrine.
Why it happens
Cocaine inhibits norepinephrine reuptake, adding to the direct adrenergic agonism of epinephrine.
What to do
Avoid additional vasoconstrictors where possible. If unavoidable, use the lowest dose and monitor ECG and vital signs for a prolonged period.
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 Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Phenelzine Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Citalopram + Cocaine 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 Cocaine with Epinephrine?
MediHelp rates the interaction as major. Cocaine 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. Cocaine blocks catecholamine reuptake, potentiating epinephrine's sympathomimetic effects. This raises the risk of hypertension, myocardial ischemia and ventricular arrhythmias.
How serious is the interaction between Cocaine 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 additional vasoconstrictors where possible. If unavoidable, use the lowest dose and monitor ECG and vital signs for a prolonged period.
What other medicines interact with Cocaine?
MediHelp also lists interactions of Cocaine with, for example, Isocarboxazid, Phenelzine, Procarbazine. The full list is on the Cocaine page.
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