Drug interactions
Epinephrine + Flecainide
Severity: Moderate
Epinephrine and Flecainide: 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
Epinephrine can provoke tachyarrhythmias and may cause hypokalemia, while flecainide has proarrhythmic potential, particularly with increased heart rate. The combination can increase ventricular arrhythmia risk, though this is relevant mainly with systemic epinephrine.
What this interaction means in plain words
Epinephrine and Flecainide 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.
Epinephrine belongs to Endocrine; Flecainide belongs to Cardiovascular.
Why it happens
Additive proarrhythmic effects from beta-adrenergic stimulation and sodium channel blockade, with possible epinephrine-induced hypokalemia.
What to do
Use epinephrine when clinically needed, such as in anaphylaxis, but monitor ECG and potassium; local anesthetic doses with epinephrine need no special action.
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 Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir 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 Epinephrine with Flecainide?
MediHelp rates the interaction as moderate. Epinephrine and Flecainide 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. Epinephrine can provoke tachyarrhythmias and may cause hypokalemia, while flecainide has proarrhythmic potential, particularly with increased heart rate. The combination can increase ventricular arrhythmia risk, though this is relevant mainly with systemic epinephrine.
How serious is the interaction between Epinephrine and Flecainide?
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 epinephrine when clinically needed, such as in anaphylaxis, but monitor ECG and potassium; local anesthetic doses with epinephrine need no special action.
What other medicines interact with Flecainide?
MediHelp also lists interactions of Flecainide with, for example, Nirmatrelvir, Nirmatrelvir / ritonavir, Pimozide. The full list is on the Flecainide page.
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