Possible Interaction: Epinephrine and Monoamine Oxidase Inhibitors

“Patients at higher risk for serious adverse effects from epinephrine are those with comorbidities such as underlying heart disease and those taking monoamine oxidase inhibitors , tricyclic antidepressants, antiarrhythmics, and cocaine [8].”

“The effect of epinephrine was potentiated by the presence of the monoamine oxidase inhibitor , pargyline (10 microM).”

“Patients may benefit to a mild degree from the anticholinergic effects of some antidepressants, but monoamine oxidase inhibitors (MAOIs) should be avoided in those who are receiving epinephrine injections or several other drugs commonly used to treat rhinitis and sinusitis.”

“Most anesthesiologists would agree that local anesthetic solutions for infiltration of skin flaps, nerve blocks in the digits or penis, or nerve … patients with severe hyperthyroidism, extreme hypertension, or marked arrhythmias (especially when ventricular in origin), and perhaps in patients receiving drugs such as monoamine-oxidase inhibitors should … epinephrine.”

“Pretreatment with monoamine oxidase inhibitor and/or 6-hydroxydopamine caused changes in the levels of endogenous catecholamine (dopamine, noradrenaline and adrenaline ) in the stomach wall.”

“into rats caused a slight reduction in hypothalamic concentration of epinephrine and completely prevented the accumulation of epinephrine after monoamine oxidase inhibition.”

“The responses to adrenaline and noradrenaline were markedly potentiated in the presence of monoamine oxidase inhibitors , guanethidine or reserpine, indicating the presence of MAO activity in the tissue and possibly catecholamine stores.”

“ Monoamine oxidase inhibitors , iprornazid and choline-p-tolyl ether, have been shown to prevent completely the ability of liver tissue to inactivate epinephrine.”