Drug interactions
Epinephrine + Trimipramine
Severity: Major
Epinephrine and Trimipramine: 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
Tricyclics block noradrenaline reuptake and can greatly potentiate the pressor and arrhythmogenic effects of epinephrine given systemically. Severe hypertension and tachyarrhythmias can result.
What this interaction means in plain words
Epinephrine and Trimipramine 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.
Epinephrine belongs to Endocrine; Trimipramine belongs to Central Nervous System.
Why it happens
Tricyclic inhibition of catecholamine reuptake, with enhanced adrenergic receptor stimulation and additive proarrhythmic effects.
What to do
Avoid systemic epinephrine where an alternative exists. When it is necessary, such as in anaphylaxis, use the lowest effective dose with continuous blood pressure and ECG monitoring.
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 Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine Contraindicated
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 Trimipramine?
MediHelp rates the interaction as major. Epinephrine and Trimipramine 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. Tricyclics block noradrenaline reuptake and can greatly potentiate the pressor and arrhythmogenic effects of epinephrine given systemically. Severe hypertension and tachyarrhythmias can result.
How serious is the interaction between Epinephrine and Trimipramine?
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 systemic epinephrine where an alternative exists. When it is necessary, such as in anaphylaxis, use the lowest effective dose with continuous blood pressure and ECG monitoring.
What other medicines interact with Trimipramine?
MediHelp also lists interactions of Trimipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Trimipramine page.
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