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Does Promethazine Hydrochloride And Dextromethorphan Hydrobromide Interact with Epinephrine?

Promethazine Hydrochloride And Dextromethorphan Hydrobromide and Epinephrine have a contraindicated drug interaction according to U.S. FDA drug labeling data. Epinephrine should NOT be used to treat hypotension associated with overdose due to promethazine's potential to reverse epinephrine's vasopressor effect. The mechanism involves promethazine reverses epinephrine's vasopressor effect. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.

Severity
Contraindicated
Epinephrine Class
alpha-Adrenergic Agonist
Management
Do not take together
Data Source
U.S. FDA via OpenFDA

How This Interaction Works

The interaction between Promethazine Hydrochloride And Dextromethorphan Hydrobromide and Epinephrine occurs because promethazine reverses epinephrine's vasopressor effect. Clinically, this means epinephrine should not be used to treat hypotension associated with overdose due to promethazine's potential to reverse epinephrine's vasopressor effect. Because of the severity of this interaction, these medications are contraindicated — meaning they should not be taken together under any circumstances. If you are currently taking both, contact your healthcare provider immediately to discuss alternatives.

What To Tell Your Doctor or Pharmacist

If you are taking Promethazine Hydrochloride And Dextromethorphan Hydrobromide and your doctor is considering prescribing Epinephrine (or vice versa), make sure to:

  • Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
  • Ask whether the benefits of combining these medications outweigh the risks for your specific situation
  • Ask what symptoms to watch for that would indicate the interaction is causing problems
  • Ask about alternative medications that do not interact with your current regimen
  • Ask how frequently you should be monitored while these are co-prescribed
  • Never stop or change either medication without first consulting your healthcare provider
💊 Promethazine Hydrochloride And Dextromethorphan Hydrobromide(Promethazine Hydrochloride And Dextromethorphan Hydrobromide)+💊 Epinephrine(Adrenalin)

Severity & Interaction Details

⛔
contraindicated
Avoid this combination
FDA labeling lists this pair as contraindicated. The risk outweighs the benefit in nearly all cases.
Severity scale
MinorContra
On record
Yes
Drug A class
—
Drug B class
alpha-Adrenergic Agonist
Source
NLP:promethazine hydrochloride and dextromethorphan hydrobromide

What this means in plain English

Epinephrine should NOT be used to treat hypotension associated with overdose due to promethazine's potential to reverse epinephrine's vasopressor effect.

What the FDA label says

"Promethazine reverses epinephrine's vasopressor effect"

📖 Source: NLP:promethazine hydrochloride and dextromethorphan hydrobromide

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Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine. For informational purposes only. Always consult your pharmacist or physician.