Drug interactions
Epinephrine inhaled + Tranylcypromine
Severity: Major
Epinephrine inhaled and Tranylcypromine: 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
Epinephrine is a direct-acting catecholamine, and MAO inhibition can exaggerate its pressor and cardiac effects. Inhaled epinephrine has less systemic exposure, but labeling prohibits its use with MAOIs because hypertension and arrhythmia may occur.
What this interaction means in plain words
Epinephrine inhaled and Tranylcypromine 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
Additive adrenergic stimulation with reduced catecholamine breakdown through MAO inhibition.
What to do
Avoid inhaled epinephrine in patients taking an MAOI or within 14 days of stopping one. Use an alternative bronchodilator such as a selective beta-2 agonist with blood pressure and heart rate 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 Tranylcypromine
- 5-HTP + Tranylcypromine Contraindicated
- Amitriptyline + Tranylcypromine Contraindicated
- Amoxapine + Tranylcypromine Contraindicated
- Atomoxetine + Tranylcypromine Contraindicated
- Benzphetamine + Tranylcypromine Contraindicated
- Brimonidine + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Epinephrine inhaled with Tranylcypromine?
MediHelp rates the interaction as major. Epinephrine inhaled and Tranylcypromine 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 is a direct-acting catecholamine, and MAO inhibition can exaggerate its pressor and cardiac effects. Inhaled epinephrine has less systemic exposure, but labeling prohibits its use with MAOIs because hypertension and arrhythmia may occur.
How serious is the interaction between Epinephrine inhaled and Tranylcypromine?
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 inhaled epinephrine in patients taking an MAOI or within 14 days of stopping one. Use an alternative bronchodilator such as a selective beta-2 agonist with blood pressure and heart rate monitoring.
What other medicines interact with Tranylcypromine?
MediHelp also lists interactions of Tranylcypromine with, for example, 5-HTP, Amitriptyline, Amoxapine. The full list is on the Tranylcypromine page.
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