Drug interactions
Epinephrine + Norepinephrine
Severity: Moderate
Epinephrine and Norepinephrine: 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
Both are catecholamines that stimulate adrenergic receptors, so combined use gives additive pressor and chronotropic effects. This can cause marked hypertension, tachycardia and arrhythmias, and epinephrine can additionally lower potassium.
What this interaction means in plain words
Epinephrine and Norepinephrine 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.
Why it happens
Additive alpha- and beta-adrenergic receptor agonism.
What to do
When both are infused, titrate each to hemodynamic targets with continuous blood pressure and ECG monitoring. Check serum potassium and lactate periodically.
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 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 Norepinephrine?
MediHelp rates the interaction as moderate. Epinephrine and Norepinephrine 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. Both are catecholamines that stimulate adrenergic receptors, so combined use gives additive pressor and chronotropic effects. This can cause marked hypertension, tachycardia and arrhythmias, and epinephrine can additionally lower potassium.
How serious is the interaction between Epinephrine and Norepinephrine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: When both are infused, titrate each to hemodynamic targets with continuous blood pressure and ECG monitoring. Check serum potassium and lactate periodically.
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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