Drug interactions
Epinephrine + Salmeterol
Severity: Moderate
Epinephrine and Salmeterol: 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 drugs stimulate beta-adrenergic receptors, so using them together can add to tachycardia, palpitations, tremor, blood pressure rise and arrhythmia risk. Both can also lower serum potassium, which adds to the arrhythmia risk, particularly in patients with cardiac disease.
What this interaction means in plain words
Epinephrine and Salmeterol 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; Salmeterol belongs to Respiratory.
Why it happens
Additive beta-adrenergic agonism, including beta-2 mediated intracellular potassium shift.
What to do
Monitor heart rate, blood pressure and ECG in at-risk patients, and check serum potassium if high doses or repeated epinephrine dosing are needed. Do not delay epinephrine in anaphylaxis.
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 Salmeterol
- Ritonavir + Salmeterol Contraindicated
- Salmeterol + Saquinavir Contraindicated
- Amitriptyline + Salmeterol Major
- Arformoterol + Salmeterol Major
- Atazanavir + Salmeterol Major
- Budesonide-formoterol + Salmeterol 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 Salmeterol?
MediHelp rates the interaction as moderate. Epinephrine and Salmeterol 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 drugs stimulate beta-adrenergic receptors, so using them together can add to tachycardia, palpitations, tremor, blood pressure rise and arrhythmia risk. Both can also lower serum potassium, which adds to the arrhythmia risk, particularly in patients with cardiac disease.
How serious is the interaction between Epinephrine and Salmeterol?
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 heart rate, blood pressure and ECG in at-risk patients, and check serum potassium if high doses or repeated epinephrine dosing are needed. Do not delay epinephrine in anaphylaxis.
What other medicines interact with Salmeterol?
MediHelp also lists interactions of Salmeterol with, for example, Ritonavir, Saquinavir, Amitriptyline. The full list is on the Salmeterol page.
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