Drug interactions
Epinephrine + Fluticasone-salmeterol
Severity: Moderate
Epinephrine and Fluticasone-salmeterol: 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 and salmeterol are both beta-adrenergic agonists, so using them together can intensify tachycardia, hypertension, tremor and hypokalemia. Patients with heart disease are at greatest risk of arrhythmia.
What this interaction means in plain words
Epinephrine and Fluticasone-salmeterol 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; Fluticasone-salmeterol belongs to Respiratory.
Why it happens
Additive beta-adrenergic stimulation affecting the heart, vasculature and cellular potassium uptake.
What to do
Monitor heart rate, blood pressure and serum potassium when both are given, particularly in cardiac patients. Epinephrine should still be given in anaphylaxis, with ECG monitoring if clinically indicated.
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 Fluticasone-salmeterol
- Darunavir + Fluticasone-salmeterol Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Fluticasone-salmeterol Contraindicated
- Fluticasone-salmeterol + Fosamprenavir Contraindicated
- Fluticasone-salmeterol + Indinavir Contraindicated
- Fluticasone-salmeterol + Lopinavir Contraindicated
- Fluticasone-salmeterol + Nelfinavir 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 Fluticasone-salmeterol?
MediHelp rates the interaction as moderate. Epinephrine and Fluticasone-salmeterol 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 and salmeterol are both beta-adrenergic agonists, so using them together can intensify tachycardia, hypertension, tremor and hypokalemia. Patients with heart disease are at greatest risk of arrhythmia.
How serious is the interaction between Epinephrine and Fluticasone-salmeterol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor heart rate, blood pressure and serum potassium when both are given, particularly in cardiac patients. Epinephrine should still be given in anaphylaxis, with ECG monitoring if clinically indicated.
What other medicines interact with Fluticasone-salmeterol?
MediHelp also lists interactions of Fluticasone-salmeterol with, for example, Darunavir, Elvitegravir / cobicistat / emtricitabine / tenofovir df, Fosamprenavir. The full list is on the Fluticasone-salmeterol page.
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