Drug interactions
Epinephrine inhaled + Propranolol
Severity: Major
Epinephrine inhaled and Propranolol: 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
Propranolol blocks beta-2 receptors, reducing the bronchodilator effect of inhaled epinephrine and may provoke bronchospasm in susceptible patients. Systemic absorption of epinephrine may also cause hypertension with reflex bradycardia under non-selective blockade.
What this interaction means in plain words
Epinephrine inhaled and Propranolol 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.
Why it happens
Non-selective beta-adrenergic antagonism opposes the beta-2 agonist action of epinephrine.
What to do
Avoid propranolol in patients with asthma or COPD needing epinephrine or bronchodilators, or switch to a cardioselective agent if a beta blocker is essential. Monitor respiratory status and blood pressure.
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 Propranolol
- Propranolol + Thioridazine Contraindicated
- Acebutolol + Propranolol Major
- Adrenaline-articaine + Propranolol Major
- Amifostine + Propranolol Major
- Amiodarone + Propranolol Major
- Arformoterol + Propranolol Major
Frequently asked questions
Can I take Epinephrine inhaled with Propranolol?
MediHelp rates the interaction as major. Epinephrine inhaled and Propranolol 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. Propranolol blocks beta-2 receptors, reducing the bronchodilator effect of inhaled epinephrine and may provoke bronchospasm in susceptible patients. Systemic absorption of epinephrine may also cause hypertension with reflex bradycardia under non-selective blockade.
How serious is the interaction between Epinephrine inhaled and Propranolol?
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 propranolol in patients with asthma or COPD needing epinephrine or bronchodilators, or switch to a cardioselective agent if a beta blocker is essential. Monitor respiratory status and blood pressure.
What other medicines interact with Propranolol?
MediHelp also lists interactions of Propranolol with, for example, Thioridazine, Acebutolol, Adrenaline-articaine. The full list is on the Propranolol page.
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