Drug interactions
Epinephrine racemic + Phenelzine
Severity: Major
Epinephrine racemic and Phenelzine: major interaction.
Last updated Sources: Health Canada product monograph
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
MAO inhibitors can increase and prolong the cardiovascular effects of epinephrine, leading to hypertension, tachycardia and arrhythmias. The risk is greatest with systemic dosing but inhaled racemic epinephrine can also contribute.
What this interaction means in plain words
Epinephrine racemic and Phenelzine 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
Impaired MAO-mediated metabolism together with increased neuronal catecholamine stores potentiates adrenergic stimulation.
What to do
Avoid where an alternative exists, and use the lowest effective dose with blood pressure and ECG monitoring if epinephrine is essential, such as in anaphylaxis.
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 Phenelzine
- 5-HTP + Phenelzine Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amoxapine + Phenelzine Contraindicated
- Atomoxetine + Phenelzine Contraindicated
- Benzphetamine + Phenelzine Contraindicated
- Brimonidine + Phenelzine Contraindicated
Frequently asked questions
Can I take Epinephrine racemic with Phenelzine?
MediHelp rates the interaction as major. Epinephrine racemic and Phenelzine 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. MAO inhibitors can increase and prolong the cardiovascular effects of epinephrine, leading to hypertension, tachycardia and arrhythmias. The risk is greatest with systemic dosing but inhaled racemic epinephrine can also contribute.
How serious is the interaction between Epinephrine racemic and Phenelzine?
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 where an alternative exists, and use the lowest effective dose with blood pressure and ECG monitoring if epinephrine is essential, such as in anaphylaxis.
What other medicines interact with Phenelzine?
MediHelp also lists interactions of Phenelzine with, for example, 5-HTP, Amitriptyline, Amoxapine. The full list is on the Phenelzine page.
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