Drug interactions
Epinephrine racemic + Phenylephrine
Severity: Moderate
Epinephrine racemic and Phenylephrine: moderate interaction.
Last updated
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
Combining racemic epinephrine with systemic phenylephrine can produce additive sympathetic effects, including hypertension, tachycardia and arrhythmia. The risk is higher in patients with heart disease, hyperthyroidism or hypertension.
What this interaction means in plain words
Epinephrine racemic and Phenylephrine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive alpha- and beta-adrenergic agonist activity.
What to do
Monitor blood pressure, heart rate and ECG when systemic phenylephrine is used with racemic epinephrine. Avoid concurrent oral decongestants in patients with cardiovascular disease.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Phenylephrine
- Isocarboxazid + Phenylephrine Contraindicated
- Phenelzine + Phenylephrine Contraindicated
- Phenylephrine + Tranylcypromine Contraindicated
- Bromocriptine + Phenylephrine Major
- Cocaine + Phenylephrine Major
- Dihydroergotamine intranasal + Phenylephrine Major
Frequently asked questions
Can I take Epinephrine racemic with Phenylephrine?
MediHelp rates the interaction as moderate. Epinephrine racemic and Phenylephrine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Combining racemic epinephrine with systemic phenylephrine can produce additive sympathetic effects, including hypertension, tachycardia and arrhythmia. The risk is higher in patients with heart disease, hyperthyroidism or hypertension.
How serious is the interaction between Epinephrine racemic and Phenylephrine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure, heart rate and ECG when systemic phenylephrine is used with racemic epinephrine. Avoid concurrent oral decongestants in patients with cardiovascular disease.
What other medicines interact with Phenylephrine?
MediHelp also lists interactions of Phenylephrine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Phenylephrine page.
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