Drug interactions
Epinephrine + Hydrochlorothiazide
Severity: Moderate
Epinephrine and Hydrochlorothiazide: 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
Both drugs can lower serum potassium, so combined use may produce additive hypokalemia. This increases the risk of arrhythmias, particularly in patients with heart disease or those on digoxin.
What this interaction means in plain words
Epinephrine and Hydrochlorothiazide 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; Hydrochlorothiazide belongs to Cardiovascular.
Why it happens
Thiazides cause renal potassium loss while epinephrine drives potassium into cells through beta-2 adrenergic stimulation, producing additive hypokalemia.
What to do
Monitor serum potassium and ECG when epinephrine is given systemically or repeatedly to patients on hydrochlorothiazide. Replace potassium as needed.
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 Hydrochlorothiazide
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 Hydrochlorothiazide?
MediHelp rates the interaction as moderate. Epinephrine and Hydrochlorothiazide 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. Both drugs can lower serum potassium, so combined use may produce additive hypokalemia. This increases the risk of arrhythmias, particularly in patients with heart disease or those on digoxin.
How serious is the interaction between Epinephrine and Hydrochlorothiazide?
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 serum potassium and ECG when epinephrine is given systemically or repeatedly to patients on hydrochlorothiazide. Replace potassium as needed.
What other medicines interact with Hydrochlorothiazide?
MediHelp also lists interactions of Hydrochlorothiazide with, for example, Dofetilide, Amifostine, Amiodarone. The full list is on the Hydrochlorothiazide page.
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