labetalol and Bronkaid mist Interactions

Interactions between labetalol and Bronkaid mist (epinephrine)

labetalol and epinephrine (Major Drug-Drug)

MONITOR CLOSELY: Nonselective beta-blockers increase the pressor response to epinephrine. When these agents are taken together, patients initially may experience severe hypertension, then bradycardia. Stroke has been reported. The mechanism is related to blockade of the beta effects of epinephrine (vasodilation and cardiac stimulation) resulting in more predominant alpha effects (vasoconstriction). If anaphylaxis occurs, beta blockers may attenuate the response to epinephrine. Topically applied epinephrine is not expected to interact.

MANAGEMENT: Extreme caution and close monitoring of blood pressure are indicated if these drugs must be used together. Withdrawal of beta-blockers before the procedure or anesthesia may increase the risk of myocardial ischemia and is not recommended. Selective beta-blockers (i.e., metoprolol, atenolol, acebutolol) may be safer alternatives.