Bupivacaine and epinephrine and Timolol interaction

Bupivacaine and epinephrine and Timolol: 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 Bupivacaine and epinephrine (Marcaine) label · effective 2026-05-29

Moderate

Risk of Hypertension and Bradycardia Due to Drug Interactions Between MARCAINE WITH EPINEPHRINE and Nonselective Beta-Adrenergic Antagonists Administration of MARCAINE WITH EPINEPHRINE (containing a vasoconstrictor) in patients receiving nonselective beta-adrenergic antagonists may cause severe hypertension and bradycardia.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Patients on beta-blockers may not manifest changes in heart rate, but blood pressure monitoring can detect a transient rise in systolic blood pressure.

Warnings and precautionsby drug classView label on DailyMed
Minor

• Nonselective Beta-Adrenergic Antagonists : Administration of MARCAINE WITH EPINEPHRINE (containing a vasoconstrictor) in patients receiving nonselective beta-adrenergic antagonists may cause severe hypertension and bradycardia.

Drug interactionsby drug classView label on DailyMed
Minor

Nonselective Beta-Adrenergic Antagonists Administration of MARCAINE WITH EPINEPHRINE (containing a vasoconstrictor) in patients receiving nonselective beta-adrenergic antagonists may cause severe hypertension and bradycardia.

Drug interactionsby drug classView label on DailyMed

From the Timolol (Timolol Maleate) label · effective 2024-11-04

Moderate

Such patients may be unresponsive to the usual doses of epinephrine used to treat anaphylactic reactions.

Warnings and precautionsnames Bupivacaine and epinephrineView label on DailyMed
Moderate

If necessary during surgery, the effects of beta-adrenergic blocking agents may be reversed by sufficient doses of adrenergic agonists.

Warnings and precautionsby drug classView label on DailyMed

Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.

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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.