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Epinephrine

Epinephrine

Drug Information

Epinephrine—also called adrenaline—is a synthetic human hormone available as an orally inhaled, nonprescription drug to relieve temporary shortness of breath, chest tightness, and wheezing due to bronchial asthma . Epinephrine is also available as a prescription drug used by injection in emergencies, including acute asthma attacks and severe allergic reactions.

Common brand names:

EpiPen, EpiPen Jr

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • none

Reduce Side Effects

  • none

Support Medicine

  • Coleus

    A test tube study demonstrated that the bronchodilating effects of salbutamol, a drug with similar actions in the lung to epinephrine, were significantly increased by the addition of forskolin, the active component of the herb Coleus forskohlii.1 The results of this preliminary research suggest that the combination of forskolin and beta-agonists might provide an alternative to raising the doses of the beta-agonist drugs as they lose effectiveness. Until more is known, coleus should not be combined with epinephrine without the supervision of a doctor.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduces Effectiveness

  • none

Potential Negative Interaction

  • Ephedra

    Ephedra is the plant from which the drug ephedrine was originally isolated. Epinephrine and ephedrine have similar effects and side effects.3 Until 2004, ephedra—also called ma huang—was used in many herbal products, including supplements promoted for weight loss . While interactions between epinephrine and ephedra have not been reported, it seems likely that such interactions could occur. To prevent potential problems, people should not be taking both epinephrine and ephedra/ephedrine-containing products.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Foods with Caffeine

    Epinephrine can increase blood pressure and heart rate.5 Caffeine, especially in large amounts, can also increase heart rate.6 When given with phenylpropanolamine , a drug with effects similar to epinephrine, caffeine has been shown to produce an additive increase in blood pressure.7 Caffeine is found in coffee, tea, soft drinks, chocolate, guaraná  (Paullinia cupana), nonprescription drugs, and supplements containing caffeine or guaraná. While no interactions have been reported between epinephrine and caffeine, people using epinephrine can minimize the potential for interactions by limiting or avoiding caffeine.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Explanation Required 

  • Magnesium

    Intravenous administration of epinephrine to human volunteers reduced plasma concentrations of vitamin C .11 Epinephrine and other “stress hormones” may reduce intracellular concentrations of potassium and magnesium .12 Although there are no clinical studies in humans, it seems reasonable that individuals using epinephrine should consume a diet high in vitamin C, potassium, and magnesium, or should consider supplementing with these nutrients.

  • Potassium

    Intravenous administration of epinephrine to human volunteers reduced plasma concentrations of vitamin C .15 Epinephrine and other “stress hormones” may reduce intracellular concentrations of potassium and magnesium .16 Although there are no clinical studies in humans, it seems reasonable that individuals using epinephrine should consume a diet high in vitamin C, potassium, and magnesium, or should consider supplementing with these nutrients.

  • Vitamin C

    Intravenous administration of epinephrine to human volunteers reduced plasma concentrations of vitamin C .19 Epinephrine and other “stress hormones” may reduce intracellular concentrations of potassium and magnesium .20 Although there are no clinical studies in humans, it seems reasonable that individuals using epinephrine should consume a diet high in vitamin C, potassium, and magnesium, or should consider supplementing with these nutrients.

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

1. Yousif MH, Thulesius O. Forskolin reverses tachyphylaxis to the bronchodilator effects of salbutamol: an in-vitro study on isolated guinea-pig trachea. J Pharm Pharmacol 1999;51:181-6.

2. Yousif MH, Thulesius O. Forskolin reverses tachyphylaxis to the bronchodilator effects of salbutamol: an in-vitro study on isolated guinea-pig trachea. J Pharm Pharmacol 1999;51:181-6.

3. Threlkeld DS, ed. Respiratory Drugs, Bronchodilators, Sympathomimetics. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1994, 177-a.

4. Threlkeld DS, ed. Respiratory Drugs, Bronchodilators, Sympathomimetics. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1994, 177-a.

5. Threlkeld DS, ed. Respiratory Drugs, Bronchodilators, Sympathomimetics. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1994, 177-a.

6. Threlkeld DS, ed. Central Nervous System Drugs, Analeptics, Caffeine. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1998, 230-d.

7. Brown NJ, Ryder D, Branch RA. A pharmacodynamic interaction between caffeine and phenylpropanolamine. Clin Pharmacol Ther 1991;50:363-71.

8. Threlkeld DS, ed. Respiratory Drugs, Bronchodilators, Sympathomimetics. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1994, 177-a.

9. Threlkeld DS, ed. Central Nervous System Drugs, Analeptics, Caffeine. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1998, 230-d.

10. Brown NJ, Ryder D, Branch RA. A pharmacodynamic interaction between caffeine and phenylpropanolamine. Clin Pharmacol Ther 1991;50:363-71.

11. Cox BD, Clarkson AR, Whichelow MJ, et al. Effect of adrenaline on plasma vitamin C levels in normal subjects. Horm Metab Res 1974;6:234-7.

12. Raab W. Cardiotoxic effects of emotional, socioeconomic, and environmental stresses. In Myocardiology, vol I, ed. E Bajusz, G Rona. Baltimore: University Park Press 1970, 707-13.

13. Cox BD, Clarkson AR, Whichelow MJ, et al. Effect of adrenaline on plasma vitamin C levels in normal subjects. Horm Metab Res 1974;6:234-7.

14. Raab W. Cardiotoxic effects of emotional, socioeconomic, and environmental stresses. In Myocardiology, vol I, ed. E Bajusz, G Rona. Baltimore: University Park Press 1970, 707-13.

15. Cox BD, Clarkson AR, Whichelow MJ, et al. Effect of adrenaline on plasma vitamin C levels in normal subjects. Horm Metab Res 1974;6:234-7.

16. Raab W. Cardiotoxic effects of emotional, socioeconomic, and environmental stresses. In Myocardiology, vol I, ed. E Bajusz, G Rona. Baltimore: University Park Press 1970, 707-13.

17. Cox BD, Clarkson AR, Whichelow MJ, et al. Effect of adrenaline on plasma vitamin C levels in normal subjects. Horm Metab Res 1974;6:234-7.

18. Raab W. Cardiotoxic effects of emotional, socioeconomic, and environmental stresses. In Myocardiology, vol I, ed. E Bajusz, G Rona. Baltimore: University Park Press 1970, 707-13.

19. Cox BD, Clarkson AR, Whichelow MJ, et al. Effect of adrenaline on plasma vitamin C levels in normal subjects. Horm Metab Res 1974;6:234-7.

20. Raab W. Cardiotoxic effects of emotional, socioeconomic, and environmental stresses. In Myocardiology, vol I, ed. E Bajusz, G Rona. Baltimore: University Park Press 1970, 707-13.

21. Cox BD, Clarkson AR, Whichelow MJ, et al. Effect of adrenaline on plasma vitamin C levels in normal subjects. Horm Metab Res 1974;6:234-7.

22. Raab W. Cardiotoxic effects of emotional, socioeconomic, and environmental stresses. In Myocardiology, vol I, ed. E Bajusz, G Rona. Baltimore: University Park Press 1970, 707-13.

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