Drug interactions
Epinephrine + Ibutilide
Severity: Major
Epinephrine and Ibutilide: major interaction.
Last updated Sources: Health Canada product monograph
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
Ibutilide markedly prolongs repolarization and carries a risk of torsades de pointes, and epinephrine adds arrhythmogenic stimulation and potassium shifts. The combination increases ventricular arrhythmia risk.
What this interaction means in plain words
Epinephrine and Ibutilide 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.
Epinephrine belongs to Endocrine; Ibutilide belongs to Cardiovascular.
Why it happens
Additive proarrhythmic effect of catecholamine stimulation with potassium channel blockade and QT prolongation.
What to do
Avoid unless epinephrine is needed for life-saving use. Monitor ECG continuously and keep potassium and magnesium normal.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Epinephrine and Ibutilide, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Ibutilide
- Amiodarone + Ibutilide Contraindicated
- Amisulpride + Ibutilide Contraindicated
- Chlorpromazine + Ibutilide Contraindicated
- Clarithromycin + Ibutilide Contraindicated
- Desipramine + Ibutilide Contraindicated
- Dolasetron + Ibutilide Contraindicated
Frequently asked questions
Can I take Epinephrine with Ibutilide?
MediHelp rates the interaction as major. Epinephrine and Ibutilide 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. Ibutilide markedly prolongs repolarization and carries a risk of torsades de pointes, and epinephrine adds arrhythmogenic stimulation and potassium shifts. The combination increases ventricular arrhythmia risk.
How serious is the interaction between Epinephrine and Ibutilide?
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 unless epinephrine is needed for life-saving use. Monitor ECG continuously and keep potassium and magnesium normal.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
