Drug interactions
Epinephrine + Methylenedioxymethamphetamine
Severity: Major
Epinephrine and Methylenedioxymethamphetamine: major interaction.
Last updated Sources: US FDA label
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
MDMA releases catecholamines and inhibits their reuptake, and it raises heart rate and blood pressure. Giving epinephrine on top of this may cause severe hypertension, tachyarrhythmias and cardiac ischemia.
What this interaction means in plain words
Epinephrine and Methylenedioxymethamphetamine 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.
Why it happens
Additive sympathomimetic effects from MDMA-induced catecholamine release and direct adrenergic receptor stimulation by epinephrine.
What to do
In MDMA intoxication, avoid epinephrine unless it is essential, such as for anaphylaxis or cardiac arrest, and use the lowest effective dose. Monitor blood pressure, ECG and temperature continuously.
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?
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References
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 Methylenedioxymethamphetamine?
MediHelp rates the interaction as major. Epinephrine and Methylenedioxymethamphetamine 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. MDMA releases catecholamines and inhibits their reuptake, and it raises heart rate and blood pressure. Giving epinephrine on top of this may cause severe hypertension, tachyarrhythmias and cardiac ischemia.
How serious is the interaction between Epinephrine and Methylenedioxymethamphetamine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: In MDMA intoxication, avoid epinephrine unless it is essential, such as for anaphylaxis or cardiac arrest, and use the lowest effective dose. Monitor blood pressure, ECG and temperature continuously.
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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