Drug interactions
Epinephrine racemic + Metoprolol
Severity: Major
Epinephrine racemic and Metoprolol: 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
Beta-blockers can blunt the effects of epinephrine, including bronchodilation. Unopposed alpha stimulation may cause marked hypertension and reflex bradycardia, and the response to anaphylaxis treatment may be reduced.
What this interaction means in plain words
Epinephrine racemic and Metoprolol 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
Beta-adrenergic blockade antagonizes epinephrine beta effects while alpha-mediated vasoconstriction is unopposed.
What to do
Monitor blood pressure and heart rate closely after epinephrine; in refractory anaphylaxis on beta-blockers consider glucagon.
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 Metoprolol
- Metoprolol + Thioridazine Contraindicated
- Amifostine + Metoprolol Major
- Amiodarone + Metoprolol Major
- Atenolol-chlorthalidone + Metoprolol Major
- Atenolol + Metoprolol Major
- Betaxolol + Metoprolol Major
Frequently asked questions
Can I take Epinephrine racemic with Metoprolol?
MediHelp rates the interaction as major. Epinephrine racemic and Metoprolol 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. Beta-blockers can blunt the effects of epinephrine, including bronchodilation. Unopposed alpha stimulation may cause marked hypertension and reflex bradycardia, and the response to anaphylaxis treatment may be reduced.
How serious is the interaction between Epinephrine racemic and Metoprolol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure and heart rate closely after epinephrine; in refractory anaphylaxis on beta-blockers consider glucagon.
What other medicines interact with Metoprolol?
MediHelp also lists interactions of Metoprolol with, for example, Thioridazine, Amifostine, Amiodarone. The full list is on the Metoprolol page.
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