This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Beta-blockers may block the effects of epinephrine.
What might happen:
Taking beta-blockers with epinephrine may cause your blood pressure to be increased. Your heart rate may slow down.The effect of epinephrine on severe allergic reactions may be decreased if you are also taking beta-blockers.
What you should do about this interaction:
Avoid taking these medications together. If they are taken together, your blood pressure and heart rate should be closely monitored. If you carry epinephrine as a precaution against allergic reactions, discuss the fact that you are also taking a beta-blocker with your doctor and what to do in the event of an emergency situation.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
- 1.Ichinohe T, Igarashi O, Kaneko Y. The influence of propranolol on the cardiovascular effects and plasma clearance of epinephrine. Anesth Prog 1991 Nov-Dec;38(6):217-20.
- 2.Mackie K, Lam A. Epinephrine-containing test dose during beta-blockade. J Clin Monit 1991 Jul;7(3):213-6.
- 3.Houben H, Thien T, De Boo T, Lemmens W, Van Herwaarden CL, Fennis JF, Van 't Laar A. Influence of selective and non-selective beta-adrenoreceptor blockade on the haemodynamic effect of adrenaline during combined antihypertensive drug therapy. Clin Sci (Lond) 1979 Dec;57 Suppl 5:397s-399s.
- 4.Newman BR, Schultz LK. Epinephrine-resistant anaphylaxis in a patient taking propranolol hydrochloride. Ann Allergy 1981 Jul;47(1):35-7.
- 5.Harris WS, Schoenfeld CD, Brooks RH, Weissler AM. Effect of beta adrenergic blockade on the hemodynamic responses to epinephrine in man. Am J Cardiol 1966 Apr;17(4):484-92.
- 6.Kram J, Bourne HR, Melmon KL, Maibach H. Letter: Propranolol. Ann Intern Med 1974 Feb;80(2):282.
- 7.Niwa H, Shibutani T, Hori T, Kim Y, Akita M, Matsuura H. The interaction between pindolol and epinephrine contained in local anesthetic solution to the left ventricular diastolic filling velocity in normal subjects. Anesth Prog 1996 Summer;43(3):78-84.
- 8.Schechtman SA, Wertz AP, Shanks A, Thompson A, Tremper K, Pynnonen MA, Healy DW. Preoperative beta-blockade and hypertension in the first hour of functional endoscopic sinus surgery. Laryngoscope 2017 Jul; 127(7):1496-1505.
- 9.Sugimura M, Hirota Y, Shibutani T, Niwa H, Hori T, Kim Y, Matsuura H. An echocardiographic study of interactions between pindolol and epinephrine contained in a local anesthetic solution. Anesth Prog 1995;42(2):29-35.
- 10.van Herwaarden CLA, Binkhorst RA, Fennis JFM, Van't Laar A. Effects of adrenaline during treatment with propranolol and metoprolol. Br Med J 1977 Apr;1(6067):1029.
- 11.Foster CA, Aston SJ. Propranolol-epinephrine interaction: a potential disaster. Plast Reconstr Surg 1983 Jul;72(1):74-8.
- 12.Hansbrough JF, Near A. Propranolol-Epinephrine antagonism with hypertension and stroke. Ann Intern Med 1980;92(5):717.
- 13.Gandy W. Severe epinephrine-propranolol interaction. Ann Emerg Med 1989 Jan;18(1):98-9.
- 14.Whelan TV. Propranolol, epinephrine, and accelerated hypertension during hemodialysis. Ann Intern Med 1987 Feb;106(2):327.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.