Use Caution/Monitor.propranololMonitor Closely (1)propranolol decreases effects of epinephrine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. Beta2-adrenergic blockers may may inhibit bronchodilatory effects of epinephrine.protriptylineMonitor Closely (1)protriptyline and epinephrine inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Tricyclic antidepressants may potentiate epinephrine effect on cardiovascular system.pseudoephedrineMonitor Closely (1)pseudoephedrine, epinephrine inhaled. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.serdexmethylphenidate/dexmethylphenidateMonitor Closely (1)serdexmethylphenidate/dexmethylphenidate, epinephrine inhaled. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.sotalolMonitor Closely (1)sotalol decreases effects of epinephrine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. Beta2-adrenergic blockers may may inhibit bronchodilatory effects of epinephrine.timololMonitor Closely (1)timolol decreases effects of epinephrine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. Beta2-adrenergic blockers may may inhibit bronchodilatory effects of epinephrine.tolcaponeMonitor Closely (1)tolcapone will increase the level or effect of epinephrine inhaled by decreasing metabolism. Use Caution/Monitor. Tolcapone is a COMT inhibitor. Caution if coadministered with drugs metabolized by COMT. If coadministered, monitor for changes in heart rate, heart rhythm, and blood pressure.tranylcypromineContraindicated (1)tranylcypromine and epinephrine inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Contraindicated. Coadministration of epinephrine inhaled with MAOIs or within 2 weeks after discontinuing an MAOI is contraindicated.trimipramineMonitor Closely (1)trimipramine and epinephrine inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Tricyclic antidepressants may potentiate epinephrine effect on cardiovascular system. Frequency Not Defined Tachycardia Increased blood pressure Contraindications Undiagnosed pulmonary symptoms Coadministration with MAOIs, or within 2 weeks after discontinuing an MAOI Cautions Patients who have severe asthma or who have been hospitalized for asthma should seek medical attention for prescription medications to treat their asthma Caution with preexisting conditions, including heart disease (eg, arrhythmias, coronary insufficiency, elevated blood pressure [BP]), diabetes, urinary impairment, enlarged prostate, thyroid disease, seizures, or narrow-angle glaucoma May increase heart rate (HR) or BP Not for relief of COPD symptoms Drug interaction overview Coadministration with MAOIs or within 2 weeks after discontinuing an MAOI is contraindicated, owing to risk for hypertensive episode Tricyclic antidepressants may potentiate epinephrine effect on cardiovascular system Other stimulants (eg, phenylephrine, pseudoephedrine, ephedrine, caffeine) may have additive effects on HR or BP Caution with beta-blockers; may block bronchodilatory effects of epinephrine Pregnancy Control of asthma during pregnancy is essential for maternal and fetal health In women with poorly or moderately controlled asthma, there is increased risk of preeclampsia in mother and prematurity, low birth weight, and small for gestational age in neonate; pregnant women should be closely monitored and medication adjusted as necessary to maintain optimal control Beta-agonists may interfere with uterine contractility during labor Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs Lactation Unknown if inhaled epinephrine is distributed in human milk Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugsPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Elicits beta1- and beta2-adrenergic effects, resulting in bronchial smooth muscle relaxation Also has alpha-adrenergic effects that may increase HR and BP Inhaled Administration For oral inhalation only Before first use only: Shake inhaler and spray into air; repeat both actions 4 times to assure inhaler is activated Before subsequent doses (ie, 1-2 inhalations): Shake inhaler then spray into air once to prime After each day of use: Wash by removing red cap and container; run water through mouthpiece for 30 seconds, then shake off excess water and let dry Storage Store at room temperature between 15-25°C (59-77°F) Do not store near open flame No images available for this drug. No images available for this drug.A Patient Handout is not currently available for this monograph.Print