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Interactions between Isuprel Mistometer and Methylene blue

1 drug interaction and 7 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

isoproterenol methylene blue

Applies to: Isuprel Mistometer (isoproterenol) and methylene blue
Monitor

Monoamine oxidase inhibitors (MAOIs) can potentiate the cardiovascular adverse effects of beta-2 adrenergic agonists such as hypertension, palpitation, tachycardia, and chest pain.

Management

Cardiovascular status should be closely monitored when beta-2 agonists are coadministered with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, linezolid, methylene blue, procarbazine). Preferably, at least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with beta-2 agonists.

References (18)
  1. Finch JS (1981) "Cardiovascular toxicity: clinical evaluation of albuterol, isoproterenol and placebo in rising dose tolerance trial." Ann Allergy, 47, p. 402-4
  2. (1985) "Adverse effects and complications of treatment with beta-adrenergic agonist drugs. Committee on drugs, the American Academy of Allergy and Immunology." J Allergy Clin Immunol, 75, p. 443-9
  3. (2002) "Product Information. Proventil (albuterol)." Schering Corporation
  4. (2001) "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals
  5. (2001) "Product Information. Isuprel (isoproterenol)." Sanofi Winthrop Pharmaceuticals
  6. "Product Information. Serevent (salmeterol)." Glaxo Wellcome
  7. (2001) "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals
  8. Boakes AJ, Laurence DR, Teoh PC, Barar FS, Benedikter LT, Prichard BN (1973) "Interactions between sympathomimetic amines and antidepressant agents in man." Br Med J, 1, p. 311-5
  9. Darcy PF, Griffin JP (1995) "Interactions with drugs used in the treatment of depressive illness." Adverse Drug React Toxicol Rev, 14, p. 211-31
  10. (2001) "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim
  11. (2022) "Product Information. Tornalate (bitolterol)." Apothecon Inc
  12. (2001) "Product Information. Xopenex (levalbuterol)." Sepracor Inc
  13. (2001) "Product Information. Foradil (formoterol)." Novartis Pharmaceuticals
  14. (2006) "Product Information. Brovana (arformoterol)." Sepracor Inc
  15. (2010) "Product Information. S2 Inhalant (racepinephrine)." Nephron Pharmaceuticals
  16. (2011) "Product Information. Arcapta Neohaler (indacaterol)." Novartis Pharmaceuticals
  17. (2013) "Product Information. Breo Ellipta (fluticasone-vilanterol)." GlaxoSmithKline
  18. (2014) "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

isoproterenol Caffeine

Applies to: Isuprel Mistometer (isoproterenol)
Monitor

Coadministration of two or more sympathomimetic or noradrenergic agents may increase the risk of nervousness, irritability, tachycardia, and/or increased blood pressure. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic and/or noradrenergic agents, including norepinephrine transporter inhibitors. 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 or noradrenergic agents are coadministered. Pulse and blood pressure should be closely monitored. Consultation with individual product labeling, as well as relevant institutional protocols, may be advisable for further guidance.

References (20)
  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. (2024) "Product Information. Ephedrine (ephedrine)." Hameln Pharma Ltd
  8. (2023) "Product Information. Ephedrine Hydrochloride (ephedrine)." Wockhardt UK Ltd
  9. (2026) "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company
  10. (2025) "Product Information. Atomoxetine (atomoxetine)." Zentiva Pharma UK Ltd
  11. (2026) "Product Information. Atomoxetine (Apo) (atomoxetine)." Arrotex Pharmaceuticals Pty Ltd
  12. Angita Pharma, Inc (2026) AG-ATOMOXETINE Product Monograph (Health Canada) https://pdf.hres.ca/dpd_pm/00059014.PDF
  13. (2026) "Product Information. Boots Decongestant (Pseudoephedrine) (pseudoephedrine)." The Boots Company Plc
  14. (2023) "Product Information. Sinus and Nasal Decongestant (Trust) (pseudoephedrine)." Noumed Pharmaceuticals Pty Ltd
  15. (2019) "Product Information. Ephedrine (ephedrine)." Pfizer Australia Pty Ltd
  16. (2024) "Product Information. EPHEDrine Sulfate (ePHEDrine)." Amneal Pharmaceuticals LLC
  17. (2024) "Product Information. Lemsip Cough Max for Mucus Cough and Cold (guaifenesin/paracetamol/phenylephrine)." Reckitt Benckiser Healthcare (UK) Ltd
  18. emc (2026) Product information: sudafed plus blocked nose 1mg/50mg/ml nasal spray. https://www.medicines.org.uk/emc/product/14256/smpc?utm_source=chatgpt.com
  19. (2023) "Product Information. EPHEDrine Sulfate (ePHEDrine)." Baxter Corporation
  20. Neo Health (OTC) Pty Ltd (2026) Product information: pseudoephedrine hydrochloride-paracetamol capsules. https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2024-PI-02603-1&d=20260804172310101&d=20260827172310101

Disease interactions

6 potential interactions Applies to: 6 conditions, including Angina, Tachyarrhythmia, Dehydration, Acidosis, and Renal Dysfunction.

Acidosis

Moderate:

Isuprel Mistometer

The isoproterenol in Isuprel Mistometer has a moderate potential interaction with Acidosis.

Acidosis, hypoxia, and hypercapnia may reduce the effectiveness of sympathomimetic amines in raising blood pressure. These conditions should be corrected before initiating therapy with sympathomimetic amines, if possible. Monitoring the patients acid-base balance, carbon dioxide levels, and oxygen saturation is recommended.

Angina

Major:

Isuprel Mistometer

The isoproterenol in Isuprel Mistometer has a major potential interaction with Angina.

The use of isoproterenol is contraindicated in patients with tachyarrhythmias; tachycardia or heart block caused by digitalis intoxication; ventricular arrhythmias which require inotropic therapy; and angina pectoris.

Dehydration

Major:

Isuprel Mistometer

The isoproterenol in Isuprel Mistometer has a major potential interaction with Dehydration.

The use of sympathomimetic amines has been infrequently associated with significant hypotension especially in dehydrated patients secondary to the drug's beta-2 mediated vasodilation. Hypovolemia should be corrected, if possible, before administering sympathomimetic amines. Blood pressure and ECG should be monitored at regular intervals. Monitoring of cardiac output and pulmonary wedge pressure may also be desired.

G-6-PD Deficiency

Major:

methylene blue

Methylene blue has a major potential interaction with G-6-PD Deficiency.

The use of methylene blue is contraindicated for the treatment of methemoglobinemia in patients with glucose-6-phosphate deficiency (G-6-PD). Methylene blue will not reverse the condition in patients with G-6-PD and may precipitate acute hemolysis in these patients.

Renal Dysfunction

Moderate:

methylene blue

Methylene blue has a moderate potential interaction with Renal Dysfunction.

Methylene blue is reduced in tissues to leukomethylene blue, and both are excreted by the kidney. The serum concentrations of methylene blue and leukomethylene blue may be increased in patients with impaired renal function. Therapy with methylene blue should be avoided in patients with severe renal impairment and administered cautiously in patients with mild to moderate renal impairment. Dosage adjustments may be necessary.

Tachyarrhythmia

Major:

Isuprel Mistometer

The isoproterenol in Isuprel Mistometer has a major potential interaction with Tachyarrhythmia.

The use of isoproterenol is contraindicated in patients with tachyarrhythmias; tachycardia or heart block caused by digitalis intoxication; ventricular arrhythmias which require inotropic therapy; and angina pectoris.

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More resources

Isuprel Mistometer

A total of 435 drugs are known to interact with Isuprel Mistometer.

methylene blue

A total of 201 drugs are known to interact with methylene blue.

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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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