Drug interactions
Epinephrine + Midodrine
Severity: Moderate
Epinephrine and Midodrine: 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
Midodrine is an alpha-1 agonist and epinephrine is a catecholamine, so using them together can produce additive pressor effects. Blood pressure may rise excessively and reflex bradycardia or arrhythmias may occur.
What this interaction means in plain words
Epinephrine and Midodrine 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; Midodrine belongs to Miscellaneous.
Why it happens
Additive alpha-adrenergic vasoconstriction and sympathomimetic activity.
What to do
Monitor blood pressure and heart rate closely when both are given, and titrate epinephrine to the lowest effective dose. Avoid supine hypertension by limiting midodrine dosing near bedtime.
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 Midodrine
- Isocarboxazid + Midodrine Contraindicated
- Midodrine + Phenelzine Contraindicated
- Midodrine + Tranylcypromine Contraindicated
- Dextroamphetamine + Midodrine Major
- Dihydroergotamine intranasal + Midodrine Major
- Dihydroergotamine + Midodrine Major
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 Midodrine?
MediHelp rates the interaction as moderate. Epinephrine and Midodrine 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. Midodrine is an alpha-1 agonist and epinephrine is a catecholamine, so using them together can produce additive pressor effects. Blood pressure may rise excessively and reflex bradycardia or arrhythmias may occur.
How serious is the interaction between Epinephrine and Midodrine?
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 blood pressure and heart rate closely when both are given, and titrate epinephrine to the lowest effective dose. Avoid supine hypertension by limiting midodrine dosing near bedtime.
What other medicines interact with Midodrine?
MediHelp also lists interactions of Midodrine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Midodrine page.
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