Epinephrine and Mepivacaine interaction

Epinephrine and Mepivacaine: the Mepivacaine 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 Mepivacaine (Polocaine-MPF) label · effective 2022-10-01

Major

Mepivacaine with epinephrine or other vasopressors should not be used concomitantly with ergot-type oxytocic drugs, because a severe persistent hypertension may occur.

Warningsnames EpinephrineView label on DailyMed
Moderate

Likewise, solutions of mepivacaine containing a vasoconstrictor, such as epinephrine, should be used with extreme caution in patients receiving monoamine oxidase inhibitors (MAOI) or antidepressants of the triptyline or imipramine types, because severe prolonged hypertension may result.

Warningsnames EpinephrineView label on DailyMed
Moderate

Clinically Significant Drug Interactions The administration of local anesthetic solutions containing epinephrine or norepinephrine to patients receiving monoamine oxidase inhibitors or tricyclic antidepressants may produce severe, prolonged hypertension.

Drug interactionsnames EpinephrineView label on DailyMed
Moderate

Phenothiazines and butyrophenones may reduce or reverse the pressor effect of epinephrine.

Drug interactionsnames EpinephrineView label on DailyMed
Moderate

Drug Interactions The administration of local anesthetic solutions containing epinephrine or norepinephrine to patients receiving monoamine oxidase inhibitors or tricyclic antidepressants may produce severe, prolonged hypertension.

Precautionsnames 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.