Dosing & Uses
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
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 (57)
- 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.
- levoketoconazole
epinephrine racemic and levoketoconazole 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 (251)
- 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.
- serdexmethylphenidate/dexmethylphenidate
epinephrine racemic and serdexmethylphenidate/dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. 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 chloride/magnesium sulfate/polyethylene glycol
epinephrine racemic and sodium sulfate/potassium chloride/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.
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
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
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.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
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.
Patient Handout
racepinephrine inhalation
RACEPINEPHRINE - ORAL INHALATION
(RAYSE-ep-i-NEF-rin)
COMMON BRAND NAME(S): Asthmanefrin
USES: Racepinephrine is used to treat wheezing and shortness of breath caused by asthma. Controlling these symptoms can decrease time lost from work or school. Racepinephrine belongs to a class of drugs known as bronchodilators. It works by relaxing the muscles around the airways so that they open up and you can breathe more easily. Use this medication only if you have been told by your doctor that you have asthma.
HOW TO USE: If you are using the over-the-counter product to self-treat, read all directions on the product package before using this medication. If you have any questions, consult your pharmacist. If your doctor has prescribed this medication, use it as directed.This product is used with a special breathing device (such as an atomizer or nebulizer) that changes the solution to a fine mist that you inhale. Do not swallow or inject the solution. Do not mix with other medicines in your breathing device. Learn all instructions for proper use of this medication and the device. Make sure you understand how to properly clean the device to prevent infections. If you have any questions, consult your doctor, pharmacist, or respiratory therapist.Before using, check this product visually for discoloration or particles. Do not use if the solution looks brown or cloudy, or if it contains particles.Inhale this medication into your lungs using the breathing device usually every 3 hours as needed. If a child is using this medication, an adult should supervise the child. Do not use again for at least 3 hours. Do not use more than 12 vials in a 24-hour period.Caffeine can increase the side effects of this medication. Avoid drinking large amounts of beverages containing caffeine (coffee, tea, colas), eating large amounts of chocolate, or taking nonprescription products that contain caffeine.If your breathing does not get better within 20 minutes after using this medication, if your breathing gets worse, or if you think you may have a serious medical problem, get medical help right away.
SIDE EFFECTS: Headache, dizziness, nausea, vomiting, trouble sleeping, anxiety, nervousness, shakiness, sweating, or pale skin may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.Tell your doctor right away if you have any serious side effects, including: fast/pounding/irregular heartbeat, mental/mood changes (such hallucinations).Rarely, this medication may cause severe (rarely fatal), sudden worsening of breathing problems (rebound bronchospasm). If you notice a sudden worsening of breathing/wheezing, get medical help right away.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or 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: Before using racepinephrine, tell your doctor or pharmacist if you are allergic to it; or to epinephrine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.If you have any of the following health problems, consult your doctor or pharmacist before using this product: heart problems (such as irregular heartbeat, high blood pressure), diabetes, overactive thyroid, mental/mood disorders (such as depression), Parkinson's disease, seizures, glaucoma (narrow angle), enlarged prostate.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially the effects on the heart.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: some beta blockers (such as propranolol).Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Do not take any MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop using this medication.
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: Lab and/or medical tests (such as blood pressure, heart rate) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.Avoid substances that can worsen breathing problems by causing irritation or allergic reaction, such as smoke, pollen, pet dander, dust, and mold.Learn to use a peak flow meter, use it daily, and promptly report worsening breathing problems (such as readings in the yellow/red range, increased use of quick-relief inhalers).Because the flu virus can worsen breathing problems, ask your doctor or pharmacist if you should have a flu shot every year.
MISSED DOSE: Not applicable.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.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.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised March 2023. Copyright(c) 2023 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.
