Drug interactions
Epinephrine + Metolazone
Severity: Moderate
Epinephrine and Metolazone: 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 drives potassium into cells through beta-2 stimulation, and metolazone causes renal potassium loss, so hypokalemia may be additive. Low potassium can increase the risk of arrhythmias in patients receiving epinephrine.
What this interaction means in plain words
Epinephrine and Metolazone 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; Metolazone belongs to Cardiovascular.
Why it happens
Beta-2 mediated cellular potassium uptake combined with diuretic-induced urinary potassium loss.
What to do
Monitor serum potassium and cardiac rhythm when epinephrine is given in patients on metolazone, and replace potassium as 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 Metolazone
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 Metolazone?
MediHelp rates the interaction as moderate. Epinephrine and Metolazone 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 drives potassium into cells through beta-2 stimulation, and metolazone causes renal potassium loss, so hypokalemia may be additive. Low potassium can increase the risk of arrhythmias in patients receiving epinephrine.
How serious is the interaction between Epinephrine and Metolazone?
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 cardiac rhythm when epinephrine is given in patients on metolazone, and replace potassium as indicated.
What other medicines interact with Metolazone?
MediHelp also lists interactions of Metolazone with, for example, Amifostine, Amlodipine-hydrochlorothiazide-valsartan, Amlodipine-olmesartan-hydrochlorothiazide. The full list is on the Metolazone page.
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