Articaine and epinephrine and Metoprolol and hydrochlorothiazide interaction

Articaine and epinephrine and Metoprolol and hydrochlorothiazide: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Articaine and epinephrine (Articaine Hydrochloride and Epinephrine) label · effective 2026-03-26

Moderate

The administration of local anesthetic solutions containing epinephrine to patients receiving monoamine oxidase inhibitors, nonselective beta-adrenergic antagonists, or tricyclic antidepressants may produce severe, prolonged hypertension.

Drug interactionsby drug classView label on DailyMed
Moderate

…nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine Monoamine Oxidase Inhibitors, Nonselective Beta-Adrenergic Antagonists, or Tricyclic Antidepressants: May produce severe, prolonged hypertension ( 7 )

Drug interactionsby drug classView label on DailyMed

From the Metoprolol and hydrochlorothiazide (METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE) label · effective 2025-01-22

Moderate

Patients may be unresponsive to the usual doses of epinephrine used to treat allergic reaction.

Warnings and precautionsnames Articaine and epinephrineView label on DailyMed
Moderate

Anaphylactic Reaction While taking beta-blockers, patients with a history of severe anaphylactic reactions to a variety of allergens may be more reactive to repeated challenge and may be unresponsive to the usual doses of epinephrine used to treat an allergic reaction.

Warnings and precautionsnames Articaine and epinephrineView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.