Cocaine and Prilocaine and epinephrine interaction

Cocaine and Prilocaine and epinephrine: the Cocaine prescribing label flags this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Cocaine (NUMBRINO) label · effective 2026-01-12

Major

Avoid use of additional vasoconstrictor agents such as epinephrine or phenylephrine with NUMBRINO.

Warnings and precautionsnames Prilocaine and epinephrineView label on DailyMed
Major

Avoid use of additional vasoconstrictor agents such as epinephrine and phenylephrine with NUMBRINO during nasal and sinus surgery.

Drug interactionsnames Prilocaine and epinephrineView label on DailyMed
Major

NUMBRINO is contraindicated in: patients with a known history of hypersensitivity to cocaine hydrochloride, other ester-based local anesthetics, or any other component of the nasal solution [see Warnings and Precautions ( 5.5 )] .

Contraindicationsby drug classView label on DailyMed
Major

Known Hypersensitivity or Idiosyncrasy to the Sympathomimetic Amines NUMBRINO is contraindicated in patients with a known history of hypersensitivity to cocaine or to the components of the nasal solution.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Cocaine is a sympathetic neuronal catecholamine reuptake inhibitor, which may potentiate the actions of concomitantly administered sympathomimetic amines.

Warnings and precautionsby drug classView 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.