Drug interactions
Doxepin + Epinephrine
Severity: Moderate
Doxepin 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
Doxepin can potentiate the cardiovascular effects of epinephrine by blocking norepinephrine reuptake, leading to hypertension or arrhythmias. Both drugs may also affect cardiac conduction, though topical or low-dose doxepin has less systemic effect.
What this interaction means in plain words
Doxepin 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.
Doxepin belongs to Dermatology; Epinephrine belongs to Endocrine.
Why it happens
Inhibition of neuronal norepinephrine reuptake by doxepin potentiates adrenergic effects, with additive proarrhythmic potential.
What to do
Use the lowest effective epinephrine dose and monitor blood pressure and ECG, particularly with systemic epinephrine or higher doxepin doses.
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
Other interactions of Doxepin
- Doxepin + Isocarboxazid Contraindicated
- Doxepin + Phenelzine Contraindicated
- Doxepin + Procarbazine Contraindicated
- Doxepin + Safinamide Contraindicated
- Doxepin + Selegiline Contraindicated
- Doxepin + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Doxepin with Epinephrine?
MediHelp rates the interaction as moderate. Doxepin 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. Doxepin can potentiate the cardiovascular effects of epinephrine by blocking norepinephrine reuptake, leading to hypertension or arrhythmias. Both drugs may also affect cardiac conduction, though topical or low-dose doxepin has less systemic effect.
How serious is the interaction between Doxepin 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 blood pressure and ECG, particularly with systemic epinephrine or higher doxepin doses.
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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