isoproterenol (Rx)

Brand and Other Names:Isuprel

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 0.2mg/mL

Adams-Stokes Attacks, Cardiac Arrest, or Heart Block

IV bolus: 0.02-0.06 mg (1-3 mL of a 1:50,000 dilution), initially, THEN doses of 0.01-0.2 mg

IV infusion: 5 mcg/min (1.25 mL of a 1:250,000 dilution), initially, THEN doses of 2-20 mcg/min based on patient's response

Shock

0.5-5 mcg/min (0.25-2.5 mL of a 1:250,000 dilution) IV infusion

Bronchospasm During Anesthesia

0.01-0.02 mg IV repeat PRN

Dosage Forms & Strengths

injectable solution

  • 0.2mg/mL

Adams-Stokes Attacks (Off-label)

Initial: 0.1 mcg/kg/min IV infusion  

Usual dose: 0.1-1 mcg/kg/min IV infusion

Cardiac Arrest (Off-label)

Initial: 0.1 mcg/kg/min IV infusion  

Usual dose: 0.2 to 1 mcg/kg/min

Heart Block (Off-label)

Initial: 0.1 mcg/kg/min IV infusion  

Usual dose: 0.3 to 1 mcg/kg/min IV infusion

Postoperative Cardiac Patients with Bradycardia

IV infusion: 0.029 mcg/kg/min  

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Interactions

Interaction Checker

and isoproterenol

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            Contraindicated (6)

            • isocarboxazid

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

            • linezolid

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

            • phenelzine

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

            • procarbazine

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

            • selegiline transdermal

              selegiline transdermal increases effects of isoproterenol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • tranylcypromine

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

            Serious - Use Alternative (26)

            • amitriptyline

              amitriptyline, isoproterenol. 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

              amoxapine, isoproterenol. 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.

            • cabergoline

              cabergoline, isoproterenol. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • clomipramine

              clomipramine, isoproterenol. 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 toxicity of isoproterenol by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

            • desipramine

              desipramine, isoproterenol. 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.

            • dihydroergotamine

              dihydroergotamine, isoproterenol. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • dihydroergotamine intranasal

              dihydroergotamine intranasal, isoproterenol. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • doxapram

              doxapram increases effects of isoproterenol by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.

            • doxepin

              doxepin, isoproterenol. 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.

            • ergoloid mesylates

              ergoloid mesylates, isoproterenol. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • ergotamine

              ergotamine, isoproterenol. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • ether

              ether increases toxicity of isoproterenol by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

            • imipramine

              imipramine, isoproterenol. 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.

            • isoflurane

              isoflurane increases toxicity of isoproterenol by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

            • lofepramine

              lofepramine, isoproterenol. 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.

            • maprotiline

              maprotiline, isoproterenol. 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.

            • methoxyflurane

              methoxyflurane increases toxicity of isoproterenol by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

            • methylergonovine

              methylergonovine, isoproterenol. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • nortriptyline

              nortriptyline, isoproterenol. 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.

            • ozanimod

              ozanimod increases toxicity of isoproterenol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.

            • protriptyline

              protriptyline, isoproterenol. 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 toxicity of isoproterenol by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

            • trazodone

              trazodone, isoproterenol. 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.

            • trimipramine

              trimipramine, isoproterenol. 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.

            • yohimbe

              yohimbe, isoproterenol. Mechanism: pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            Monitor Closely (239)

            • acebutolol

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

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

            • aceclofenac

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

            • acemetacin

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

            • albuterol

              albuterol and isoproterenol both decrease serum potassium. Use Caution/Monitor.

              albuterol and isoproterenol both decrease sedation. Use Caution/Monitor.

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

            • alfentanil

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

            • alprazolam

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

            • amiloride

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

            • amitriptyline

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

            • amobarbital

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

            • amoxapine

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

            • arformoterol

              arformoterol and isoproterenol both decrease serum potassium. Use Caution/Monitor.

              arformoterol and isoproterenol both decrease sedation. Use Caution/Monitor.

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

            • aripiprazole

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

            • armodafinil

              isoproterenol and armodafinil both decrease sedation. Use Caution/Monitor.

            • aspirin

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

            • aspirin rectal

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

            • atenolol

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

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

            • azelastine

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

            • belladonna and opium

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

            • bendroflumethiazide

              isoproterenol and bendroflumethiazide both decrease serum potassium. Use Caution/Monitor.

            • benperidol

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

            • benzphetamine

              isoproterenol and benzphetamine both decrease sedation. Use Caution/Monitor.

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

            • betaxolol

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

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

            • bisoprolol

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

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

            • bromocriptine

              bromocriptine, isoproterenol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Hypertension, V tach.

            • brompheniramine

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

            • bumetanide

              isoproterenol and bumetanide both decrease serum potassium. Use Caution/Monitor.

            • buprenorphine buccal

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

            • butabarbital

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

            • butalbital

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

            • butorphanol

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

            • caffeine

              isoproterenol and caffeine both decrease sedation. Use Caution/Monitor.

            • carbenoxolone

              isoproterenol and carbenoxolone both decrease serum potassium. Use Caution/Monitor.

            • carbinoxamine

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

            • carvedilol

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

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

            • celecoxib

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

            • celiprolol

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

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

            • chloral hydrate

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

            • chlordiazepoxide

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

            • chlorothiazide

              isoproterenol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.

            • chlorpheniramine

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

            • chlorpromazine

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

              chlorpromazine, isoproterenol. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • chlorthalidone

              isoproterenol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.

            • choline magnesium trisalicylate

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

            • cinnarizine

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

            • clemastine

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

            • clomipramine

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

            • clonazepam

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

            • clorazepate

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

            • clozapine

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

            • codeine

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

            • cyclizine

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

            • cyclopenthiazide

              isoproterenol and cyclopenthiazide both decrease serum potassium. Use Caution/Monitor.

            • cyproheptadine

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

            • deflazacort

              isoproterenol and deflazacort both decrease serum potassium. Use Caution/Monitor.

            • desipramine

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

            • dexchlorpheniramine

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

            • dexfenfluramine

              isoproterenol and dexfenfluramine both decrease sedation. Use Caution/Monitor.

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

            • dexmedetomidine

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

            • dexmethylphenidate

              isoproterenol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

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

            • dextroamphetamine

              isoproterenol and dextroamphetamine both decrease sedation. Use Caution/Monitor.

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

            • dextromoramide

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

            • diamorphine

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

            • diclofenac

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

            • diethylpropion

              isoproterenol and diethylpropion both decrease sedation. Use Caution/Monitor.

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

            • difenoxin hcl

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

            • diflunisal

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

            • digoxin

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

            • dimenhydrinate

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

            • diphenhydramine

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

            • diphenoxylate hcl

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

            • dipipanone

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

            • dobutamine

              dobutamine and isoproterenol both decrease serum potassium. Use Caution/Monitor.

              dobutamine and isoproterenol both decrease sedation. Use Caution/Monitor.

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

            • dopamine

              isoproterenol and dopamine both decrease sedation. Use Caution/Monitor.

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

            • dopexamine

              dopexamine and isoproterenol both decrease serum potassium. Use Caution/Monitor.

              dopexamine and isoproterenol both decrease sedation. Use Caution/Monitor.

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

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

            • doxepin

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

            • droperidol

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

            • drospirenone

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

            • entacapone

              entacapone will increase the level or effect of isoproterenol 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 isoproterenol both decrease serum potassium. Use Caution/Monitor.

              ephedrine and isoproterenol both decrease sedation. Use Caution/Monitor.

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

              ephedrine, isoproterenol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.

            • epinephrine

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

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

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

            • epinephrine racemic

              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.

            • esmolol

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

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

            • estazolam

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

            • ethacrynic acid

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

            • ethanol

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

            • etodolac

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

            • fenfluramine

              isoproterenol and fenfluramine both decrease sedation. Use Caution/Monitor.

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

            • fenoprofen

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

            • fluphenazine

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

              fluphenazine, isoproterenol. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • flurazepam

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

            • flurbiprofen

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

            • formoterol

              formoterol and isoproterenol both decrease serum potassium. Use Caution/Monitor.

              formoterol and isoproterenol both decrease sedation. Use Caution/Monitor.

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

            • furosemide

              isoproterenol and furosemide both decrease serum potassium. Use Caution/Monitor.

            • gentamicin

              isoproterenol and gentamicin both decrease serum potassium. Use Caution/Monitor.

            • green tea

              green tea increases effects of isoproterenol 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 isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • hydralazine

              hydralazine, isoproterenol. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Sympathomimetics can antagonize the activity of some antihypertensive agents.

            • hydrochlorothiazide

              isoproterenol and hydrochlorothiazide both decrease serum potassium. Use Caution/Monitor.

            • hydromorphone

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

            • hydroxyzine

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

            • ibuprofen

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

            • ibuprofen IV

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

            • iloperidone

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

            • imipramine

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

            • indacaterol, inhaled

              isoproterenol increases effects of indacaterol, inhaled by Other (see comment). Use Caution/Monitor. Comment: If additional adrenergic drugs are to be administered by any route, they should be used with caution because the sympathetic effects of indacaterol may be potentiated.

            • indapamide

              isoproterenol and indapamide both decrease serum potassium. Use Caution/Monitor.

            • indomethacin

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

            • ketoprofen

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

            • ketorolac

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

            • ketorolac intranasal

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

            • ketotifen, ophthalmic

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

            • labetalol

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

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

            • levalbuterol

              isoproterenol and levalbuterol both decrease serum potassium. Use Caution/Monitor.

              isoproterenol and levalbuterol both decrease sedation. Use Caution/Monitor.

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

            • levorphanol

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

            • lisdexamfetamine

              isoproterenol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

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

            • lofepramine

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

            • lofexidine

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

            • loprazolam

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

            • lorazepam

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

            • lormetazepam

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

            • lornoxicam

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

            • loxapine

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

            • loxapine inhaled

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

            • maprotiline

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

            • marijuana

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

            • meclofenamate

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

            • mefenamic acid

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

            • melatonin

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

            • meloxicam

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

            • meperidine

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

            • meprobamate

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

            • metaproterenol

              isoproterenol and metaproterenol both decrease serum potassium. Use Caution/Monitor.

              isoproterenol and metaproterenol both decrease sedation. Use Caution/Monitor.

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

            • methadone

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

            • methamphetamine

              isoproterenol and methamphetamine both decrease sedation. Use Caution/Monitor.

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

            • methyclothiazide

              isoproterenol and methyclothiazide both decrease serum potassium. Use Caution/Monitor.

            • methyldopa

              methyldopa increases effects of isoproterenol by unknown mechanism. Use Caution/Monitor.

            • methylenedioxymethamphetamine

              isoproterenol and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor.

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

            • methylphenidate

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

            • metolazone

              isoproterenol and metolazone both decrease serum potassium. Use Caution/Monitor.

            • metoprolol

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

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

            • midazolam

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

            • midodrine

              isoproterenol and midodrine both decrease sedation. Use Caution/Monitor.

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

            • mirtazapine

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

            • modafinil

              isoproterenol and modafinil both decrease sedation. Use Caution/Monitor.

            • morphine

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

            • motherwort

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

            • moxonidine

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

            • nabilone

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

            • nabumetone

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

            • nadolol

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

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

            • nalbuphine

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

            • naproxen

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

            • nateglinide

              isoproterenol decreases effects of nateglinide by pharmacodynamic antagonism. Use Caution/Monitor. Coadministration may reduce nateglinide's hypoglycemic action.

            • nebivolol

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

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

            • norepinephrine

              isoproterenol and norepinephrine both decrease serum potassium. Use Caution/Monitor.

              isoproterenol and norepinephrine both decrease sedation. Use Caution/Monitor.

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

            • nortriptyline

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

            • olanzapine

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

            • olodaterol inhaled

              isoproterenol 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 isoproterenol 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 isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxaprozin

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

            • oxazepam

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

            • oxycodone

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

            • oxymorphone

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

            • oxytocin

              oxytocin increases effects of isoproterenol by pharmacodynamic synergism. Use Caution/Monitor.

            • paliperidone

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

            • papaveretum

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

            • parecoxib

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

            • penbutolol

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

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

            • pentazocine

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

            • pentobarbital

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

            • perphenazine

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

              perphenazine, isoproterenol. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • phendimetrazine

              isoproterenol and phendimetrazine both decrease sedation. Use Caution/Monitor.

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

            • phenobarbital

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

            • phenoxybenzamine

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

            • phentermine

              isoproterenol and phentermine both decrease sedation. Use Caution/Monitor.

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

            • phenylephrine

              isoproterenol and phenylephrine both decrease sedation. Use Caution/Monitor.

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

            • phenylephrine PO

              isoproterenol and phenylephrine PO both decrease sedation. Use Caution/Monitor.

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

            • pholcodine

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

            • pimozide

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

            • pindolol

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

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

            • pirbuterol

              isoproterenol and pirbuterol both decrease serum potassium. Use Caution/Monitor.

              isoproterenol and pirbuterol both decrease sedation. Use Caution/Monitor.

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

            • piroxicam

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

            • potassium acid phosphate

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

            • potassium chloride

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

            • potassium citrate

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

            • primidone

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

            • prochlorperazine

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

              prochlorperazine, isoproterenol. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • promazine

              promazine, isoproterenol. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • promethazine

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

              promethazine, isoproterenol. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • propranolol

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

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

            • propylhexedrine

              isoproterenol and propylhexedrine both decrease sedation. Use Caution/Monitor.

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

            • protriptyline

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

            • pseudoephedrine

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

            • quazepam

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

            • quetiapine

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

            • rasagiline

              rasagiline increases effects of isoproterenol by pharmacodynamic synergism. Use Caution/Monitor. Avoid concomitant use if possible. Caution is advised.

            • risperidone

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

            • sacubitril/valsartan

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

            • salicylates (non-asa)

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

            • salmeterol

              isoproterenol and salmeterol both decrease serum potassium. Use Caution/Monitor.

              isoproterenol and salmeterol both decrease sedation. Use Caution/Monitor.

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

            • salsalate

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

            • scullcap

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

            • secobarbital

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

            • selegiline

              selegiline increases effects of isoproterenol by pharmacodynamic synergism. Use Caution/Monitor. Avoid concomitant use if possible. Caution is advised.

            • serdexmethylphenidate/dexmethylphenidate

              isoproterenol 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 isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

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

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

            • sotalol

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

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

            • spironolactone

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

            • succinylcholine

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

            • sufentanil

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

            • sulfasalazine

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

            • sulindac

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

            • tapentadol

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

            • temazepam

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

            • terbutaline

              isoproterenol and terbutaline both decrease serum potassium. Use Caution/Monitor.

              isoproterenol and terbutaline both decrease sedation. Use Caution/Monitor.

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

            • thioridazine

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

              thioridazine, isoproterenol. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • thiothixene

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

            • timolol

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

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

            • tolcapone

              tolcapone will increase the level or effect of isoproterenol 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 isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • tolmetin

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

            • tolvaptan

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

            • topiramate

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

            • torsemide

              isoproterenol and torsemide both decrease serum potassium. Use Caution/Monitor.

            • tramadol

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

            • trazodone

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

            • triamterene

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

            • triazolam

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

            • triclofos

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

            • trifluoperazine

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

              trifluoperazine, isoproterenol. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • trimipramine

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

            • triprolidine

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

            • xylometazoline

              isoproterenol and xylometazoline both decrease sedation. Use Caution/Monitor.

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

            • yohimbine

              isoproterenol and yohimbine both decrease sedation. Use Caution/Monitor.

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

            • ziconotide

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

            • ziprasidone

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

            Minor (29)

            • amitriptyline

              isoproterenol, amitriptyline. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • amoxapine

              isoproterenol, amoxapine. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • bendroflumethiazide

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

            • bumetanide

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

            • chlorothiazide

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

            • chlorthalidone

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

            • clomipramine

              isoproterenol, clomipramine. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • cyclopenthiazide

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

            • desipramine

              isoproterenol, desipramine. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • desmopressin

              desmopressin increases effects of isoproterenol by pharmacodynamic synergism. Minor/Significance Unknown.

            • dosulepin

              isoproterenol, dosulepin. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • doxepin

              isoproterenol, doxepin. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • ethacrynic acid

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

            • eucalyptus

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

            • furosemide

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

            • hydrochlorothiazide

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

            • imipramine

              isoproterenol, imipramine. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • indapamide

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

            • lofepramine

              isoproterenol, lofepramine. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • maprotiline

              isoproterenol, maprotiline. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • methyclothiazide

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

            • metolazone

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

            • noni juice

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

            • nortriptyline

              isoproterenol, nortriptyline. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • protriptyline

              isoproterenol, protriptyline. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • sage

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

            • torsemide

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

            • trazodone

              isoproterenol, trazodone. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • trimipramine

              isoproterenol, trimipramine. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

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            Adverse Effects

            Frequency Not Defined

            Tachycardia

            Hypertension

            Dysrhythmias

            Angina

            Dizziness

            Nervousness

            Restlessness

            Hypokalemia

            MI size increased

            Syncope

            Confusion

            Headache

            Tremor

            Nausea

            Vomiting

            Weakness,

            Tremor

            Dyspnea

            Pulmonary edema

            Diaphoresis

            Blurred vision

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            Warnings

            Contraindications

            Hypersensitivity, digitalis intoxication, angina pectoris, preexisting cardiac arrhythmias (particularly ventricular arrythmias that require inotropic treatment & tachyarrhythmias)

            Cautions

            Use caution in patients with convulsive disorders, renal disease, CAD, coronary insufficiency, DM, HTN, hyperthyroidism, hyperresponsiveness to sympathomimetic amines, elderly

            May cause thyroid storm in susceptible patients with hyperthyroidism

            May transiently increase blood glucose levels

            Cardiac effects

            • Isoproterenol hydrochloride injection should be started at lowest recommended dose and gradually increased if necessary while carefully monitoring the patient; doses sufficient to increase heart rate to more than 130 beats per minute may increase likelihood of inducing ventricular arrhythmias such increases in heart rate will also tend to increase cardiac work and oxygen requirements which may adversely affect failing heart or heart with significant degree of arteriosclerosis
            • Adequate filling of intravascular compartment by suitable volume expanders is of primary importance in most cases of shock and should precede administration of vasoactive drugs; in patients with normal cardiac function, determination of central venous pressure is a reliable guide during volume replacement; if evidence of hypoperfusion persists after adequate volume replacement, isoproterenol hydrochloride injection may be given
            • In addition to routine monitoring of systemic blood pressure, heart rate, urine flow, and electrocardiograph, monitor response to therapy by frequent determination of central venous pressure and blood gases
            • Closely observe patients in shock during isoproterenol hydrochloride injection administration; if heart rate exceeds 110 beats per minute, it may be advisable to decrease infusion rate or temporarily discontinue infusion
            • Determinations of cardiac output and circulation time may also be helpful; take appropriate measures to ensure adequate ventilation; pay attention to acid-base balance and to correction of electrolyte disturbances
            • By increasing myocardial oxygen requirements while decreasing effective coronary perfusion isoproterenol hydrochloride injection, may have deleterious effect on injured or failing heart
            • Most experts discourage use of drug as initial agent in treating cardiogenic shock following myocardial infarction; however, when low arterial pressure has been elevated by other means, isoproterenol hydrochloride injection may produce beneficial hemodynamic and metabolic effects
            • In a few patients, presumably with organic disease of AV node and branches, drug has paradoxically been reported to worsen heart block or to precipitate Adams-Stokes attacks during normal sinus rhythm or transient heart block
            • Drug is no longer recommended for cardiac arrest
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            Pregnancy & Lactation

            Pregnancy

            Prolonged experience with isoproterenol use in pregnant women over several decades, based on published literature, does not identify a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes; however, there are risks to the mother and fetus associated with isoproterenol use during labor or delivery

            Hypotension associated with shock is a medical emergency in pregnancy which can be fatal if left untreated; delaying treatment in pregnant women with hypotension associated with shock may increase the risk of maternal and fetal morbidity and mortality; life-sustaining therapy for the pregnant woman should not be withheld due to potential concerns regarding effects of isoproterenol on the fetus

            This drug usually inhibits spontaneous or oxytocin-induced contractions of the pregnant human uterus and may delay second stage of labor; avoid use during second stage of labor; avoid isoproterenol in obstetrics when maternal blood pressure exceeds 130/80 mmHg

            Although isoproterenol may improve maternal hypotension associated with shock, it may result in uterine vasoconstriction, decreased uterine blood flow, uterine atony with hemorrhage, and fetal anoxia

            Lactation

            There is no information regarding presence of this drug in milk or effects of isoproterenol on breastfed infant or on milk production; due to its short half-life, isoproterenol exposure is expected to be very low in the breastfed infant

            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

            Strong beta-1 & beta-2 effects resulting in relaxation of GI, bronchial, and uterine smooth muscle; may increase vasodilation of peripheral vasculature, and heart rate and contractility

            Pharmacokinetics

            Half-Life: 2.5-5 min

            Duration: 10-15 min (IV)

            Metabolism: Primarily in liver & lung by monoamine oxidase (MAO) & catechol-O-methyl transferase (COMT)

            Metabolites: 3-O-methyl-isoproterenol (inactive)

            Excretion: Urine (50-80%)

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            Administration

            IV Incompatibilities

            Solution Na-bicarb 5%

            Additive: Aminophylline, furosemide, NaHCO3

            IV Compatibilities

            Solution (partial list): D5W, D10W, dextrose-saline, dextrose/LR, NS, ½NS, LR, Ringer's

            Additive: atracurium, CaCl2, cimetidine, dobutamine, floxacillin, heparin, MgSO4, KCl, ranitidine, succinylcholine, verapamil, vit B/C

            Syringe: ranitidine, caffeine

            Y-site: amiodarone, atracurium, bivalirudin, cisatracurium, dexmetedomidine, epinephrine, famotidine, fenoldopam, heparin, hydrocortisone, Hextend, inamrinone, KCl, levofloxacin, milrinone, pancuronium, propofol, remifentanil, Na-nitroprusside, tacrolimus, vecuronium, vit B/C

            IV/IM Administration

            Adminster by IV infusion (requires infusion pump), or

            By direct IV, IM, or SC injection

            In extreme emergencies, by intracardiac injection

            IV Preparation

            1 mg (5 mL) in 500 mL D5W (2 mcg/mL) for IV infusion

            Storage

            Store in a cool place between 2-15°C

            Protect from light

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            isoproterenol injection
            -
            0.2 mg/mL vial
            isoproterenol injection
            -
            0.2 mg/mL solution
            isoproterenol injection
            -
            0.2 mg/mL vial
            isoproterenol injection
            -
            0.2 mg/mL vial
            isoproterenol injection
            -
            0.2 mg/mL vial
            isoproterenol injection
            -
            0.2 mg/mL vial
            isoproterenol injection
            -
            0.2 mg/mL vial
            isoproterenol injection
            -
            0.2 mg/mL solution
            isoproterenol injection
            -
            0.2 mg/mL vial
            isoproterenol injection
            -
            0.2 mg/mL vial
            isoproterenol injection
            -
            0.2 mg/mL vial
            Isuprel injection
            -
            0.2 mg/mL solution
            Isuprel injection
            -
            0.2 mg/mL solution
            Isuprel injection
            -
            0.2 mg/mL solution

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            isoproterenol injection

            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) 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.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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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.