Drug General Information (ID: DDIHXF7316)
Drug Name			Epinephrine		Drug Info		Methoxyflurane		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Vasoconstrictor Agents				Anesthetics
Structure

Mechanism of Epinephrine-Methoxyflurane Interaction (Severity Level: Major)
Increased risk of other adverse reactions (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Epinephrine				Methoxyflurane
Mechanism		Catecholamines				Increase the arrhythmogenic effects of catecholamines
Key Mechanism Factor 1
		Factor Name		Adverse reactions
		Factor Description		An adverse reaction is an unexpected negative reaction to a medication or treatment that happens even when it's used correctly.
Mechanism Description		Increased risk of adverse reactions by the combination of Epinephrine and Methoxyflurane

Recommended Action
Management		This combination should be avoided or used very cautiously. If a halogenated anesthetic and epinephrine must be used together, an epinephrine concentration of 1:100,000 or 1:200,000 is recommended. The adult dosage should not exceed 100 mcg of a 1:100,000 solution in any 10-minute period. The patient's hemodynamic status should be closely monitored. Lidocaine has a protective effect against the arrhythmogenic potential of epinephrine. Topical epinephrine appears to be relatively safe for use during anesthesia.

References
1	Product Information. Ultane (sevoflurane). Abbott Pharmaceutical, Abbott Park, IL.
2	Konchigeri HN, Shaker MH, Winnie AP "Effect of epinephrine during enflurane anesthesia." Anesth Analg 53 (1974): 894-7.[PMID: 4473933]
3	Karl HW, Swedlow DB, Lee KW, Downes JJ "Epinephrine-halothane interactions in children." Anesthesiology 58 (1983): 142-5.[PMID: 6337528]