Drug interactions
Epinephrine + Methylergonovine
Severity: Major
Epinephrine and Methylergonovine: 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
Methylergonovine is a potent vasoconstrictor ergot derivative, and epinephrine adds alpha-adrenergic vasoconstriction. Together they can cause marked hypertension and severe peripheral or coronary vasospasm with ischemia. This risk is relevant when epinephrine is used, for example in local anesthetic mixtures or anaphylaxis, in postpartum patients.
What this interaction means in plain words
Epinephrine and Methylergonovine 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 pharmacodynamic vasoconstriction through ergot-mediated vascular smooth muscle contraction plus epinephrine alpha-1 agonism.
What to do
Avoid routine concurrent use and prefer anesthetic preparations without epinephrine where possible. If epinephrine is essential, such as in anaphylaxis, give it and monitor blood pressure, limb perfusion and chest pain closely.
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 Methylergonovine?
MediHelp rates the interaction as major. Epinephrine and Methylergonovine 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. Methylergonovine is a potent vasoconstrictor ergot derivative, and epinephrine adds alpha-adrenergic vasoconstriction. Together they can cause marked hypertension and severe peripheral or coronary vasospasm with ischemia. This risk is relevant when epinephrine is used, for example in local anesthetic mixtures or anaphylaxis, in postpartum patients.
How serious is the interaction between Epinephrine and Methylergonovine?
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 routine concurrent use and prefer anesthetic preparations without epinephrine where possible. If epinephrine is essential, such as in anaphylaxis, give it and monitor blood pressure, limb perfusion and chest pain closely.
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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