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Drug Interactions between EpiPen and vasopressin

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

vasopressin EPINEPHrine

Applies to: vasopressin and EpiPen (epinephrine)

MONITOR: Concomitant use of vasopressin or desmopressin with catecholamines is expected to result in an additive effect on mean arterial blood pressure and other hemodynamic parameters. In addition, although the combination noradrenaline (norepinephrine) and vasopressin is clinically used to improve hemodynamic parameters, noradrenaline may also decrease the antidiuretic effect of vasopressin.

MANAGEMENT: The use of injectable vasopressin or large doses of intranasal or oral desmopressin with other pressor agents should only be done with careful hemodynamic monitoring. Vasopressin dosage may need to be adjusted. Consulting local protocols with respect to the dosage of vasopressin and the order of administration when used with noradrenaline is encouraged.

References

  1. (2001) "Product Information. DDAVP (desmopressin)." Rhone Poulenc Rorer
  2. (2001) "Product Information. Stimate (desmopressin)." Forest Pharmaceuticals
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  4. Cerner Multum, Inc. "Australian Product Information."
  5. Russell JA, Walley KR, Singer J, et al. (2008) "Vasopressin versus norepinephrine infusion in patients with septic shock." N Engl J Med, 358, p. 877-87
  6. Dellinger RP, Levy MM, Rhodes A, et al. (2013) "Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012." Crit Care Med, 41, p. 580-637
  7. (2017) "Product Information. Vasostrict (vasopressin)." Par Pharmaceutical Inc
  8. (2018) "Product Information. Vasopressin (vasopressin)." APP (Abraxis Pharmaceutical Products)
  9. Rhodes A, Evans LE, Alhazzani W, et al. (2017) "Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016" Intensive Care Med, 43, p. 304-77
View all 9 references

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Drug and food interactions

Moderate

vasopressin food

Applies to: vasopressin

MONITOR: Alcohol may decrease the antidiuretic effect of vasopressin. Clinical studies found that plasma vasopressin levels often decrease during alcohol consumption and increase upon cessation of consumption. In addition, alcoholics were found to have a more pronounced decrease in plasma vasopressin levels when drinking and suppressed vasopressin levels even during alcohol withdrawal as compared to non-alcoholic individuals. The mechanism of this interaction is not fully understood.

MANAGEMENT: Patients should be advised to abstain from alcohol during vasopressin treatment. Hemodynamic monitoring is suggested for patients known to drink alcohol while receiving vasopressin.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. (2017) "Product Information. Vasostrict (vasopressin)." Par Pharmaceutical Inc
  4. Taivainen H, Laitinen K, Tahtela R, Kilanmaa K, Valimaki MJ (1995) "Role of plasma vasopressin in changes of water balance accompanying acute alcohol intoxication." Alcohol Clin Exp Res, 19, p. 759-62
  5. Collins GB, Brosnihan KB, Zuti RA, Messina M, Gupta MK (1992) "Neuroendocrine, fluid balance, and thirst responses to alcohol in alcoholics." Alcohol Clin Exp Res, 16, p. 228-32
  6. Hirschl MM, Derfler K, Bieglmayer C, et al. (1994) "Hormonal derangements in patients with severe alcohol intoxication." Alcohol Clin Exp Res, 18, p. 761-6
  7. Harper KM, Knapp DJ, Criswell HE, Breese GR (2018) "Vasopressin and alcohol: A multifaceted relationship." Psychopharmacology (Berl), 235, p. 3363-79
View all 7 references

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Moderate

EPINEPHrine food

Applies to: EpiPen (epinephrine)

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.

References

  1. Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr (1979) "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res, 1, p. 45-52
  2. Cavanaugh JH, Griffith JD, Oates JA (1970) "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther, 11, p. 656
  3. (2001) "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc
  4. (2001) "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals
  5. (2001) "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals
  6. (2001) "Product Information. Focalin (dexmethylphenidate)." Mikart Inc
  7. (2002) "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company
View all 7 references

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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