Drug interactions
Epinephrine racemic + Sotalol
Severity: Major
Epinephrine racemic and Sotalol: major 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
Sotalol is a nonselective beta-blocker, so beta blockade can leave epinephrine's alpha-adrenergic effects unopposed, causing marked hypertension and reflex bradycardia. It also blunts the bronchodilator and cardiac effects of epinephrine, which matters in anaphylaxis or asthma. The legacy QT rationale is weak, but the interaction is clinically real for other reasons.
What this interaction means in plain words
Epinephrine racemic and Sotalol 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
Nonselective beta-adrenergic blockade antagonizes beta effects of epinephrine, leaving alpha-mediated vasoconstriction unopposed.
What to do
Monitor blood pressure and heart rate closely when racemic epinephrine is given to a patient on sotalol. Be ready to use glucagon if epinephrine response is inadequate 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Epinephrine racemic and Sotalol, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
Frequently asked questions
Can I take Epinephrine racemic with Sotalol?
MediHelp rates the interaction as major. Epinephrine racemic and Sotalol 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. Sotalol is a nonselective beta-blocker, so beta blockade can leave epinephrine's alpha-adrenergic effects unopposed, causing marked hypertension and reflex bradycardia. It also blunts the bronchodilator and cardiac effects of epinephrine, which matters in anaphylaxis or asthma. The legacy QT rationale is weak, but the interaction is clinically real for other reasons.
How serious is the interaction between Epinephrine racemic and Sotalol?
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 when racemic epinephrine is given to a patient on sotalol. Be ready to use glucagon if epinephrine response is inadequate in anaphylaxis.
What other medicines interact with Sotalol?
MediHelp also lists interactions of Sotalol with, for example, Arsenic trioxide, Artemether / lumefantrine, Disopyramide. The full list is on the Sotalol page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
