Drug interactions
Dosulepin + Epinephrine
Severity: Major
Dosulepin 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
Tricyclic antidepressants such as dosulepin potentiate the pressor and arrhythmogenic effects of injected epinephrine, which can cause hypertension and tachyarrhythmias. Dosulepin can also prolong the QT interval.
What this interaction means in plain words
Dosulepin 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.
Dosulepin belongs to Central Nervous System; Epinephrine belongs to Endocrine.
Why it happens
Dosulepin blocks neuronal catecholamine reuptake, increasing adrenergic response to epinephrine, with additive cardiac conduction effects.
What to do
Avoid or minimise systemic epinephrine doses and monitor blood pressure and ECG. Use the lowest effective dose when epinephrine is needed for anaphylaxis.
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 Epinephrine
- Epinephrine + Isocarboxazid Contraindicated
- Epinephrine + Phenelzine Contraindicated
- Epinephrine + Tranylcypromine Contraindicated
- Acebutolol + Epinephrine Major
- Amitriptyline + Epinephrine Major
- Amoxapine + Epinephrine Major
Other interactions of Dosulepin
- Dosulepin + Isocarboxazid Contraindicated
- Dosulepin + Phenelzine Contraindicated
- Dosulepin + Thioridazine Contraindicated
- Dosulepin + Tranylcypromine Contraindicated
- Amitriptyline + Dosulepin Major
- Buprenorphine + Dosulepin Major
Frequently asked questions
Can I take Dosulepin with Epinephrine?
MediHelp rates the interaction as major. Dosulepin 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. Tricyclic antidepressants such as dosulepin potentiate the pressor and arrhythmogenic effects of injected epinephrine, which can cause hypertension and tachyarrhythmias. Dosulepin can also prolong the QT interval.
How serious is the interaction between Dosulepin 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 or minimise systemic epinephrine doses and monitor blood pressure and ECG. Use the lowest effective dose when epinephrine is needed for anaphylaxis.
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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