epinephrine racemic (OTC)

Brand and Other Names:AsthmaNefrin, S2
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

solution for nebulization

  • 11.25mg/0.5mL (2.25% as 1.125% dextro-epinephrine and 1.125% levo-epinephrine)

Bronchial Asthma

Indicated for temporary relieve of symptoms associated with bronchial asthma (eg, shortness of breath, chest tightening, wheezing)

S2: 0.5 mL of 2.25% solution diluted in 3 mL NS via jet nebulizer q3-4hr PRN

Asthmanefrin: 1-3 inhalations of 0.5 mL of 2.25% solution via EZ Breathe Atomizer

Dosage Forms & Strengths

solution for nebulization

  • 11.25mg/0.5mL (2.25% as 1.125% dextro-epinephrine and 1.125% levo-epinephrine)

Bronchial Asthma

Indicated for temporary relieve of symptoms associated with bronchial asthma (eg, shortness of breath, chest tightening, wheezing)

Asthmanefrin

  • <4 years: Safety and efficacy not established
  • ≥4 years: 1-3 inhalations of 0.5 mL of 2.25% solution via EZ Breathe Atomizer

S2

  • <4 years old: 0.05 mL/kg via jet nebulizer (diluted to 3 mL with NS) over 15 minutes; no more than q12hr; not to exceed 0.5 mL/dose
  • ≥4 years old: 0.5 mL of 2.25% solution via jet nebulizer (diluted to 3 mL with NS) over 15 minutes q3-4 hr PRN

Use low end of dosing range for younger infants

Should observe rapid response, can be repeated q2hr in older children but monitor HR with repeated dosing

Croup

<4 years: 0.05 mL/kg of 2.25% solution (S2) via jet nebulizer (diluted to 3 mL with NS) over 15 minutes q3-4 hr PRN; not to exceed 0.5 mL/dose

≥4 years old: 0.5 mL of 2.25% solution (S2) via jet nebulizer (diluted to 3 mL with NS) over 15 minutes q3-4 hr PRN

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Interactions

Interaction Checker

and epinephrine racemic

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            Contraindicated (10)

            • arsenic trioxide

              epinephrine racemic and arsenic trioxide both increase QTc interval. Contraindicated.

            • disopyramide

              epinephrine racemic and disopyramide both increase QTc interval. Contraindicated.

            • ibutilide

              epinephrine racemic and ibutilide both increase QTc interval. Contraindicated.

            • indapamide

              epinephrine racemic and indapamide both increase QTc interval. Contraindicated.

            • iobenguane I 123

              epinephrine racemic decreases levels of iobenguane I 123 by receptor binding competition. Contraindicated. If clinically appropriate, discontinue drugs that compete for NE receptor sites for at least 5 half-lives; may cause false-negative imaging results.

            • pentamidine

              epinephrine racemic and pentamidine both increase QTc interval. Contraindicated.

            • pimozide

              epinephrine racemic and pimozide both increase QTc interval. Contraindicated.

            • procainamide

              epinephrine racemic and procainamide both increase QTc interval. Contraindicated.

            • quinidine

              epinephrine racemic and quinidine both increase QTc interval. Contraindicated.

            • sotalol

              epinephrine racemic and sotalol both increase QTc interval. Contraindicated.

            Serious - Use Alternative (56)

            • amiodarone

              epinephrine racemic and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.

            • amitriptyline

              epinephrine racemic and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

              amitriptyline, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • amoxapine

              epinephrine racemic and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • artemether/lumefantrine

              epinephrine racemic and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • chlorpromazine

              epinephrine racemic and chlorpromazine both increase QTc interval. Avoid or Use Alternate Drug.

            • clarithromycin

              epinephrine racemic and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.

            • clomipramine

              epinephrine racemic and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.

              clomipramine, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • desflurane

              desflurane increases levels of epinephrine racemic by decreasing metabolism. Contraindicated.

            • desipramine

              epinephrine racemic and desipramine both increase QTc interval. Avoid or Use Alternate Drug.

              desipramine, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • dofetilide

              epinephrine racemic and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.

            • dosulepin

              epinephrine racemic and dosulepin both increase QTc interval. Avoid or Use Alternate Drug.

            • doxepin

              epinephrine racemic and doxepin both increase QTc interval. Avoid or Use Alternate Drug.

              doxepin, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • dronedarone

              epinephrine racemic and dronedarone both increase QTc interval. Avoid or Use Alternate Drug.

            • droperidol

              epinephrine racemic and droperidol both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin base

              epinephrine racemic and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin ethylsuccinate

              epinephrine racemic and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin lactobionate

              epinephrine racemic and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin stearate

              epinephrine racemic and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.

            • etomidate

              etomidate increases levels of epinephrine racemic by decreasing metabolism. Contraindicated.

            • fluconazole

              epinephrine racemic and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • fluphenazine

              epinephrine racemic and fluphenazine both increase QTc interval. Avoid or Use Alternate Drug.

            • formoterol

              epinephrine racemic and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

            • haloperidol

              epinephrine racemic and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.

            • imipramine

              epinephrine racemic and imipramine both increase QTc interval. Avoid or Use Alternate Drug.

              imipramine, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • isocarboxazid

              isocarboxazid increases effects of epinephrine racemic by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • ketamine

              ketamine increases levels of epinephrine racemic by unknown mechanism. Avoid or Use Alternate Drug.

            • ketoconazole

              epinephrine racemic and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • levomilnacipran

              levomilnacipran increases levels of epinephrine racemic by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of paroxysmal HTN, arrhythmia.

            • linezolid

              linezolid increases effects of epinephrine racemic by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • lofepramine

              epinephrine racemic and lofepramine both increase QTc interval. Avoid or Use Alternate Drug.

              lofepramine, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • lumefantrine

              epinephrine racemic and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • maprotiline

              epinephrine racemic and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

              maprotiline, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • milnacipran

              milnacipran increases levels of epinephrine racemic by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of paroxysmal HTN, arrhythmia.

            • moxifloxacin

              epinephrine racemic and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • nadolol

              nadolol increases effects of epinephrine racemic by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of hypertension and bradycardia. Consider selective beta 1 blocker (e.g., metoprolol).

            • nortriptyline

              epinephrine racemic and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.

              nortriptyline, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • octreotide

              epinephrine racemic and octreotide both increase QTc interval. Avoid or Use Alternate Drug.

            • octreotide (Antidote)

              epinephrine racemic and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.

            • perphenazine

              epinephrine racemic and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.

            • phenelzine

              phenelzine increases effects of epinephrine racemic by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • pindolol

              pindolol increases effects of epinephrine racemic by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of hypertension and bradycardia. Consider selective beta 1 blocker (e.g., metoprolol).

            • procarbazine

              procarbazine increases effects of epinephrine racemic by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • prochlorperazine

              epinephrine racemic and prochlorperazine both increase QTc interval. Avoid or Use Alternate Drug.

            • promazine

              epinephrine racemic and promazine both increase QTc interval. Avoid or Use Alternate Drug.

            • promethazine

              epinephrine racemic and promethazine both increase QTc interval. Avoid or Use Alternate Drug.

            • propofol

              propofol increases levels of epinephrine racemic by unknown mechanism. Avoid or Use Alternate Drug.

            • propranolol

              propranolol increases effects of epinephrine racemic by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of hypertension and bradycardia. Consider selective beta 1 blocker (e.g., metoprolol).

            • protriptyline

              epinephrine racemic and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.

              protriptyline, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • sevoflurane

              sevoflurane increases levels of epinephrine racemic by unknown mechanism. Avoid or Use Alternate Drug.

            • thioridazine

              epinephrine racemic and thioridazine both increase QTc interval. Avoid or Use Alternate Drug.

            • timolol

              timolol increases effects of epinephrine racemic by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of hypertension and bradycardia. Consider selective beta 1 blocker (e.g., metoprolol).

            • tranylcypromine

              tranylcypromine increases effects of epinephrine racemic by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • trazodone

              epinephrine racemic and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

              trazodone, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • trifluoperazine

              epinephrine racemic and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.

            • trimipramine

              epinephrine racemic and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.

              trimipramine, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • ziprasidone

              epinephrine racemic and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.

            Monitor Closely (250)

            • acebutolol

              acebutolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              acebutolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • aceclofenac

              aceclofenac increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • acemetacin

              acemetacin increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • albuterol

              albuterol and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.

              albuterol and epinephrine racemic both decrease sedation. Use Caution/Monitor.

              albuterol and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • alfentanil

              alfentanil increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • alprazolam

              alprazolam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • amiloride

              amiloride increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • amitriptyline

              amitriptyline increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              amitriptyline increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • amobarbital

              amobarbital increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • amoxapine

              amoxapine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              amoxapine increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • arformoterol

              arformoterol and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.

              arformoterol and epinephrine racemic both decrease sedation. Use Caution/Monitor.

              arformoterol and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • aripiprazole

              aripiprazole increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • armodafinil

              epinephrine racemic and armodafinil both decrease sedation. Use Caution/Monitor.

            • aspirin

              aspirin increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • aspirin rectal

              aspirin rectal increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • aspirin/citric acid/sodium bicarbonate

              aspirin/citric acid/sodium bicarbonate increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • atenolol

              atenolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              atenolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • azelastine

              azelastine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • azithromycin

              epinephrine racemic and azithromycin both increase QTc interval. Use Caution/Monitor.

            • belladonna and opium

              belladonna and opium increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • bendroflumethiazide

              epinephrine racemic and bendroflumethiazide both decrease serum potassium. Use Caution/Monitor.

            • benperidol

              benperidol increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • benzphetamine

              epinephrine racemic and benzphetamine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and benzphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • betaxolol

              betaxolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              betaxolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • bisoprolol

              bisoprolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              bisoprolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • brompheniramine

              brompheniramine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • bumetanide

              epinephrine racemic and bumetanide both decrease serum potassium. Use Caution/Monitor.

            • buprenorphine buccal

              buprenorphine buccal increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • butabarbital

              butabarbital increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • butalbital

              butalbital increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • butorphanol

              butorphanol increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • caffeine

              epinephrine racemic and caffeine both decrease sedation. Use Caution/Monitor.

            • carbenoxolone

              epinephrine racemic and carbenoxolone both decrease serum potassium. Use Caution/Monitor.

            • carbinoxamine

              carbinoxamine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • carvedilol

              carvedilol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              carvedilol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • celecoxib

              celecoxib increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • celiprolol

              celiprolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              celiprolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • chloral hydrate

              chloral hydrate increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chlordiazepoxide

              chlordiazepoxide increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chlorothiazide

              epinephrine racemic and chlorothiazide both decrease serum potassium. Use Caution/Monitor.

            • chlorpheniramine

              chlorpheniramine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chlorpromazine

              chlorpromazine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              chlorpromazine decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.

            • chlorthalidone

              epinephrine racemic and chlorthalidone both decrease serum potassium. Use Caution/Monitor.

            • choline magnesium trisalicylate

              choline magnesium trisalicylate increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • cinnarizine

              cinnarizine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clemastine

              clemastine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clomipramine

              clomipramine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              clomipramine increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • clonazepam

              clonazepam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clorazepate

              clorazepate increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clozapine

              clozapine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              clozapine decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.

            • codeine

              codeine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • cyclizine

              cyclizine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • cyclopenthiazide

              epinephrine racemic and cyclopenthiazide both decrease serum potassium. Use Caution/Monitor.

            • cyproheptadine

              cyproheptadine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • deflazacort

              epinephrine racemic and deflazacort both decrease serum potassium. Use Caution/Monitor.

            • desipramine

              desipramine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              desipramine increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • dexchlorpheniramine

              dexchlorpheniramine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dexfenfluramine

              epinephrine racemic and dexfenfluramine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and dexfenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dexmedetomidine

              dexmedetomidine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dexmethylphenidate

              epinephrine racemic and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dextroamphetamine

              epinephrine racemic and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dextromoramide

              dextromoramide increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diamorphine

              diamorphine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diclofenac

              diclofenac increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diethylpropion

              epinephrine racemic and diethylpropion both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and diethylpropion both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • difenoxin hcl

              difenoxin hcl increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diflunisal

              diflunisal increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • digoxin

              digoxin increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dimenhydrinate

              dimenhydrinate increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diphenhydramine

              diphenhydramine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diphenoxylate hcl

              diphenoxylate hcl increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dipipanone

              dipipanone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dobutamine

              dobutamine and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.

              dobutamine and epinephrine racemic both decrease sedation. Use Caution/Monitor.

              dobutamine and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dolasetron

              epinephrine racemic and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.

            • dopamine

              epinephrine racemic and dopamine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and dopamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dopexamine

              dopexamine and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.

              dopexamine and epinephrine racemic both decrease sedation. Use Caution/Monitor.

              dopexamine and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

              dopexamine, epinephrine racemic. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.

            • doxepin

              doxepin increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              doxepin increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • droperidol

              droperidol increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • drospirenone

              drospirenone increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • entacapone

              entacapone will increase the level or effect of epinephrine racemic by decreasing metabolism. Use Caution/Monitor. Entacapone is a COMT inhibitor. Caution if coadministered with drugs metabolized by COMT. If coadministered, monitor for changes in heart rate, heart rhythm, and blood pressure.

            • ephedrine

              ephedrine and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.

              ephedrine and epinephrine racemic both decrease sedation. Use Caution/Monitor.

              ephedrine and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • epinephrine

              epinephrine and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.

              epinephrine and epinephrine racemic both decrease sedation. Use Caution/Monitor.

              epinephrine and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

              epinephrine, epinephrine racemic. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely.

            • esmolol

              esmolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              esmolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • estazolam

              estazolam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ethacrynic acid

              epinephrine racemic and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

            • ethanol

              ethanol increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • etodolac

              etodolac increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fenfluramine

              epinephrine racemic and fenfluramine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and fenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • fenoprofen

              fenoprofen increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • flecainide

              epinephrine racemic and flecainide both increase QTc interval. Modify Therapy/Monitor Closely.

            • fluoxetine

              epinephrine racemic and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.

            • fluphenazine

              fluphenazine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              fluphenazine decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.

            • flurazepam

              flurazepam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • flurbiprofen

              flurbiprofen increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fluvoxamine

              fluvoxamine and epinephrine racemic both increase QTc interval. Modify Therapy/Monitor Closely.

            • formoterol

              formoterol and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.

              formoterol and epinephrine racemic both decrease sedation. Use Caution/Monitor.

              formoterol and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • foscarnet

              epinephrine racemic and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.

            • furosemide

              epinephrine racemic and furosemide both decrease serum potassium. Use Caution/Monitor.

            • gentamicin

              epinephrine racemic and gentamicin both decrease serum potassium. Use Caution/Monitor.

            • green tea

              green tea increases effects of epinephrine racemic by pharmacodynamic synergism. Use Caution/Monitor. Due to caffeine content. Combination may increase CNS stimulatory effects due to caffeine in green tea.

            • haloperidol

              haloperidol increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • hydrochlorothiazide

              epinephrine racemic and hydrochlorothiazide both decrease serum potassium. Use Caution/Monitor.

            • hydromorphone

              hydromorphone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • hydroxyzine

              hydroxyzine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ibuprofen

              ibuprofen increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ibuprofen IV

              ibuprofen IV increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • iloperidone

              epinephrine racemic and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely.

              iloperidone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • imipramine

              imipramine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              imipramine increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • indapamide

              epinephrine racemic and indapamide both decrease serum potassium. Use Caution/Monitor.

            • indomethacin

              indomethacin increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • isoproterenol

              isoproterenol and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.

              isoproterenol and epinephrine racemic both decrease sedation. Use Caution/Monitor.

              isoproterenol and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • ketoprofen

              ketoprofen increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ketorolac

              ketorolac increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ketorolac intranasal

              ketorolac intranasal increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • ketotifen, ophthalmic

              ketotifen, ophthalmic increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • labetalol

              labetalol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              labetalol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • levalbuterol

              levalbuterol and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.

              levalbuterol and epinephrine racemic both decrease sedation. Use Caution/Monitor.

              levalbuterol and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • levofloxacin

              epinephrine racemic and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • levorphanol

              levorphanol increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lisdexamfetamine

              epinephrine racemic and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • lofepramine

              lofepramine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              lofepramine increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • lofexidine

              lofexidine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • loprazolam

              loprazolam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lorazepam

              lorazepam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lormetazepam

              lormetazepam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lornoxicam

              lornoxicam increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • loxapine

              loxapine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • loxapine inhaled

              loxapine inhaled increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • maprotiline

              maprotiline increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              maprotiline increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • marijuana

              marijuana increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • meclofenamate

              meclofenamate increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • mefenamic acid

              mefenamic acid increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • melatonin

              melatonin increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • meloxicam

              meloxicam increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • meperidine

              meperidine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • meprobamate

              meprobamate increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • metaproterenol

              metaproterenol and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.

              metaproterenol and epinephrine racemic both decrease sedation. Use Caution/Monitor.

              metaproterenol and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • methadone

              epinephrine racemic and methadone both increase QTc interval. Modify Therapy/Monitor Closely.

              methadone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • methamphetamine

              epinephrine racemic and methamphetamine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and methamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • methyclothiazide

              epinephrine racemic and methyclothiazide both decrease serum potassium. Use Caution/Monitor.

            • methylenedioxymethamphetamine

              epinephrine racemic and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and methylenedioxymethamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • methylphenidate

              epinephrine racemic and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • metolazone

              epinephrine racemic and metolazone both decrease serum potassium. Use Caution/Monitor.

            • metoprolol

              metoprolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              metoprolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • midazolam

              midazolam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • midodrine

              epinephrine racemic and midodrine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and midodrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • mirtazapine

              mirtazapine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • modafinil

              epinephrine racemic and modafinil both decrease sedation. Use Caution/Monitor.

            • morphine

              morphine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • motherwort

              motherwort increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • moxonidine

              moxonidine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nabilone

              nabilone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nabumetone

              nabumetone increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nadolol

              nadolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              nadolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • nalbuphine

              nalbuphine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • naproxen

              naproxen increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nebivolol

              nebivolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              nebivolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • norepinephrine

              norepinephrine and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.

              norepinephrine and epinephrine racemic both decrease sedation. Use Caution/Monitor.

              norepinephrine and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • nortriptyline

              nortriptyline increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              nortriptyline increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • ofloxacin

              epinephrine racemic and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • olanzapine

              olanzapine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • olodaterol inhaled

              epinephrine racemic and olodaterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Caution with coadministration of adrenergic drugs by any route because of additive sympathetic effects

            • opicapone

              opicapone will increase the level or effect of epinephrine racemic by decreasing metabolism. Use Caution/Monitor. Opicapone is a COMT inhibitor. Caution if coadministered with drugs metabolized by COMT. If coadministered, monitor for changes in heart rate, heart rhythm, and blood pressure.

            • opium tincture

              opium tincture increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxaprozin

              oxaprozin increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxazepam

              oxazepam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxycodone

              oxycodone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxymorphone

              oxymorphone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • paliperidone

              epinephrine racemic and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.

              paliperidone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • papaveretum

              papaveretum increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • parecoxib

              parecoxib increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • paroxetine

              epinephrine racemic and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.

            • penbutolol

              penbutolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              penbutolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • pentazocine

              pentazocine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pentobarbital

              pentobarbital increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • perphenazine

              perphenazine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              perphenazine decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.

            • phendimetrazine

              epinephrine racemic and phendimetrazine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and phendimetrazine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • phenobarbital

              phenobarbital increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenoxybenzamine

              phenoxybenzamine, epinephrine racemic. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Hypotension, tachycardia.

            • phentermine

              epinephrine racemic and phentermine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • phentolamine

              phentolamine, epinephrine racemic. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Hypotension, tachycardia.

            • phenylephrine

              epinephrine racemic and phenylephrine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and phenylephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • phenylephrine PO

              epinephrine racemic and phenylephrine PO both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and phenylephrine PO both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • pholcodine

              pholcodine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pimozide

              pimozide increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pindolol

              pindolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              pindolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • pirbuterol

              pirbuterol and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.

              pirbuterol and epinephrine racemic both decrease sedation. Use Caution/Monitor.

              pirbuterol and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • piroxicam

              piroxicam increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • posaconazole

              epinephrine racemic and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • potassium acid phosphate

              potassium acid phosphate increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • potassium chloride

              potassium chloride increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • potassium citrate

              potassium citrate increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • primidone

              primidone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • prochlorperazine

              prochlorperazine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              prochlorperazine decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.

            • promazine

              promazine decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.

            • promethazine

              promethazine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              promethazine decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.

            • propranolol

              propranolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              propranolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • propylhexedrine

              epinephrine racemic and propylhexedrine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and propylhexedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • protriptyline

              protriptyline increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              protriptyline increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • pseudoephedrine

              epinephrine racemic and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • quazepam

              quazepam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • quetiapine

              quetiapine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ranolazine

              epinephrine racemic and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.

            • risperidone

              epinephrine racemic and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.

              risperidone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • romidepsin

              epinephrine racemic and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.

            • sacubitril/valsartan

              sacubitril/valsartan increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • salicylates (non-asa)

              salicylates (non-asa) increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • salmeterol

              epinephrine racemic and salmeterol both decrease serum potassium. Use Caution/Monitor.

              epinephrine racemic and salmeterol both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and salmeterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • salsalate

              salsalate increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • scullcap

              scullcap increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • secobarbital

              secobarbital increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • shepherd's purse

              shepherd's purse increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol

              epinephrine racemic and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.

            • solriamfetol

              epinephrine racemic and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • sotalol

              sotalol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              sotalol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • spironolactone

              spironolactone increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • succinylcholine

              succinylcholine increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sufentanil

              sufentanil increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sulfamethoxazole

              epinephrine racemic and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • sulfasalazine

              sulfasalazine increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sulindac

              sulindac increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • tapentadol

              tapentadol increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • telavancin

              epinephrine racemic and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.

            • temazepam

              temazepam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • terbutaline

              epinephrine racemic and terbutaline both decrease serum potassium. Use Caution/Monitor.

              epinephrine racemic and terbutaline both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and terbutaline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • thioridazine

              thioridazine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              thioridazine decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.

            • thiothixene

              thiothixene increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • timolol

              timolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              timolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

            • tolcapone

              tolcapone will increase the level or effect of epinephrine racemic by decreasing metabolism. Use Caution/Monitor. Tolcapone is a COMT inhibitor. Caution if coadministered with drugs metabolized by COMT. If coadministered, monitor for changes in heart rate, heart rhythm, and blood pressure.

            • tolfenamic acid

              tolfenamic acid increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • tolmetin

              tolmetin increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • tolvaptan

              tolvaptan increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • topiramate

              topiramate increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • torsemide

              epinephrine racemic and torsemide both decrease serum potassium. Use Caution/Monitor.

            • tramadol

              tramadol increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • trazodone

              trazodone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trazodone increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • triamterene

              triamterene increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • triazolam

              triazolam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • triclofos

              triclofos increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • trifluoperazine

              trifluoperazine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.

            • trimethoprim

              epinephrine racemic and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.

            • trimipramine

              trimipramine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trimipramine increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • triprolidine

              triprolidine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • tropisetron

              epinephrine racemic and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.

            • venlafaxine

              epinephrine racemic and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.

            • voriconazole

              epinephrine racemic and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • xylometazoline

              epinephrine racemic and xylometazoline both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and xylometazoline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • yohimbine

              epinephrine racemic and yohimbine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and yohimbine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • ziconotide

              ziconotide increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ziprasidone

              ziprasidone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            Minor (17)

            • bendroflumethiazide

              epinephrine racemic, bendroflumethiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • bumetanide

              epinephrine racemic, bumetanide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • chlorothiazide

              epinephrine racemic, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • chlorthalidone

              epinephrine racemic, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • cyclopenthiazide

              epinephrine racemic, cyclopenthiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • ethacrynic acid

              epinephrine racemic, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • eucalyptus

              eucalyptus increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

            • furosemide

              epinephrine racemic, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • hydrochlorothiazide

              epinephrine racemic, hydrochlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • indapamide

              epinephrine racemic, indapamide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • methyclothiazide

              epinephrine racemic, methyclothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • metolazone

              epinephrine racemic, metolazone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • noni juice

              noni juice increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

            • sage

              sage increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

            • thiothixene

              thiothixene decreases effects of epinephrine racemic by pharmacodynamic antagonism. Minor/Significance Unknown.

            • torsemide

              epinephrine racemic, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • vasopressin

              epinephrine racemic decreases effects of vasopressin by pharmacodynamic antagonism. Minor/Significance Unknown.

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            Adverse Effects

            Frequency Not Defined

            Tachycardia

            Arrhythmias

            Headache

            Nausea

            Sweating

            Tremor

            Restlessness

            Rebound airway edema may occur

            Angina

            Autonomic hyperreflexia

            Cardiac dysrhythmia

            Ventricular fibrillation

            Cerebral hemorrhage

            Pulmonary edema

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            Warnings

            Contraindications

            Epiglottitis

            Coadministration with MAOIs, or within 2 weeks after discontinuing an MAOI

            Cautions

            For oral inhalation only

            Because asthma may be life threatening, instruc patient to seek immediate medial attention when not relieved within 20 minutes, feeling worse after treatment, need more inhalations than recommended for 24 hours, have more than 2 asthma attacks in a week

            Do not use if product is brown in color or cloudy, pinkish or darker than slightly yellow, or if it contains a precipitate

            Only used when diagnosed with asthma by healthcare practitioner

            Not for use if taking a prescription for monoamine oxidase inhibitor (MAOI; certain drugs taken for depression, psychiatric or emotional conditions, or Parkinson’s disease), or for 2 weeks after stopping the MAOI drug

            If patient not sure if prescription drug contains an MAOI, ask doctor or a pharmacist before using product

            Before using, patient should ask healthcare professional especially if history of hospitalization for asthma, heart disease, high blood pressure, diabetes, trouble urinating due to an enlarged prostate gland, thyroid disease, seizures, narrow-angle glaucoma

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Excreted in breast milk

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Elicits agonistic action on alpha, beta-2, and beta-2 receptors resulting in bronchial smooth muscle relaxation, cardiac stimulation, vasodilation in skeletal muscle, and stimulation of glycogenolysis in the liver

            Pharmacokinetics

            Onset: 1-5 min

            Duration: 1-3 hr

            Metabolism: liver

            Metabolites: metanephrine & 3-methoxy-4-hydroxymandelic acid (vanillylmandelic acid, VMA)

            Excretion: unknown

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            S2 Racepinephrine inhalation
            -
            2.25 % nebulizer soln
            Asthmanefrin Refill inhalation
            -
            2.25 % nebulizer soln

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            racepinephrine inhalation

            NO MONOGRAPH AVAILABLE AT THIS TIME

            USES: Consult your pharmacist.

            HOW TO USE: Consult your pharmacist.

            SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Consult your pharmacist.

            DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

            NOTES: No monograph available at this time.

            MISSED DOSE: Consult your pharmacist.

            STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

            Information last revised July 2016. Copyright(c) 2021 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.