EpiPen (epinephrine) is a prescription drug that’s used as an emergency treatment for severe allergic reactions, including anaphylaxis. This drug can interact with other medications. For example, EpiPen can interact with certain heart medications and certain antihistamines.
EpiPen can be used in adults and children. The drug comes as a prefilled, single-dose injection pen. It contains the active ingredient epinephrine. (An active ingredient is what makes a drug work.)
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about EpiPen’s possible interactions. And for more information about EpiPen, including details about its uses, see this article.
Note: In this article, EpiPen and EpiPen Jr are referred to as “EpiPen” because they have the same interactions.
EpiPen is not known to interact with alcohol. It’s safe to use EpiPen even if you’ve consumed alcohol.
If you have other questions about alcohol and EpiPen, talk with your doctor or pharmacist.
Before you’re prescribed EpiPen, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether EpiPen interacts with supplements, herbs, and vitamins, see the “Are there other interactions with EpiPen?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with EpiPen. Keep in mind that this table does not include all drugs that may interact with EpiPen. For more information about some of these interactions, see the “Drug interactions explained” section below
Learn more about certain drug interactions that can occur with EpiPen.
Interaction with anti-arrhythmic drugs
EpiPen interacts with antiarrhythmic drugs. These are medications prescribed to treat an abnormal heart rhythm.
Examples of antiarrhythmic medications include:
What could happen
If you take an antiarrhythmic drug, using a dose of EpiPen could cause your heart to develop a ventricular arrhythmia, which is a serious abnormal heart rhythm requiring immediate medical treatment.
What you can do
Immediately after using EpiPen, call 911 or go to the nearest emergency department. Let the healthcare professionals helping you know that you take an antiarrhythmic drug. They can closely monitor you for symptoms of ventricular arrhythmia.
Because there aren’t other treatments for life threatening allergic reactions, doctors still typically prescribe EpiPen to people taking an antiarrhythmic drug.
Interaction with beta-blockers
EpiPen interacts with a group of drugs called beta-blockers. Doctors prescribe these drugs to treat certain heart conditions, including heart failure and high blood pressure. Beta-blockers are also used as antiarrhythmic drugs. (To learn about the interaction between EpiPen and these drugs, see the section directly above.)
Examples of beta-blockers include:
What could happen
If you’re taking a beta-blocker and administer a dose of EpiPen, the drugs may prevent the other drug from working properly.
For example, using EpiPen causes your blood pressure and heart rate to increase. Some people take metoprolol to lower their blood pressure or heart rate.
What you can do
Because there aren’t other treatments for life threatening allergic reactions, doctors still typically prescribe EpiPen to people taking a beta-blocker. If you take one of these drugs and administer a dose of EpiPen, a healthcare professional will closely monitor your blood pressure and heart rate afterward.
Interaction with ergot alkaloids
EpiPen interacts with ergot alkaloids, which are used to treat a migraine episode.
Examples of ergot alkaloids include:
- ergotamine (Ergomar)
- ergotamine/caffeine (Migergot)
- dihydroergotamine (Migranal, Trudhesa)
What could happen
If you take a dose of an ergot alkaloid and use EpiPen, you may experience severely high blood pressure and narrowing of your blood vessels.
In some cases, the interaction between ergot alkaloid and EpiPen may lead to a hypertensive emergency.
What you can do
Doctors typically won’t prescribe EpiPen with an ergot alkaloid. Because there aren’t alternatives to EpiPen for treating life threatening allergic reactions, your doctor can suggest other migraine treatments for you instead.
EpiPen may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with EpiPen.
Does EpiPen interact with supplements?
Before you’re prescribed EpiPen, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
EpiPen interactions with herbs
EpiPen interacts with St. John’s wort, which is a herbal supplement that some people use to ease symptoms of depression and other conditions.
If you take St. John’s wort and use EpiPen, you may experience severely high blood pressure. Immediately after using EpiPen, call 911 or go to the nearest emergency department. Let the healthcare professionals helping you know that you take St. John’s wort. They can monitor your blood pressure after you’ve used EpiPen.
Your doctor can suggest alternatives to St. John’s wort that don’t interact with EpiPen.
EpiPen and vitamins
There are currently no reports of EpiPen interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using EpiPen.
Does EpiPen interact with food?
There are currently no reports of EpiPen interacting with food. If you have questions about eating certain foods during your treatment with EpiPen, talk with your doctor.
Does EpiPen interact with vaccines?
There are currently no reports of EpiPen interacting with vaccines. If you have questions about receiving vaccines during your treatment with EpiPen, talk with your doctor.
Does EpiPen interact with lab tests?
There are currently no reports of EpiPen interacting with lab tests. If you have questions about having lab tests during your treatment with EpiPen, talk with your doctor.
Does EpiPen interact with cannabis or CBD?
There are currently no reports of EpiPen interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with EpiPen.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with EpiPen. Before being prescribed EpiPen, talk with your doctor about your health history. They’ll still likely prescribe EpiPen for you, but they may advise you to watch for certain symptoms after using a dose.
Health conditions or other factors that might interact with EpiPen include:
Diabetes. If you have diabetes, you may experience high blood sugar after administering a dose of EpiPen. Because there aren’t other treatments for life threatening allergic reactions, doctors still typically prescribe EpiPen to people with diabetes.
Immediately after using EpiPen, call 911 or go to the nearest emergency department. Let the healthcare professionals helping you know that you have diabetes. They can monitor your blood sugar and treat it if it becomes high after you’ve used EpiPen.
Heart condition. If you have a heart condition, including high blood pressure or an abnormal heart rhythm, using EpiPen may cause angina or ventricular arrhythmia. Because there aren’t other treatments for life threatening allergic reactions, doctors still typically prescribe to people with a heart condition. They can monitor you for any symptoms of an irregular heart rhythm after you use EpiPen or EpiPen Jr.
Parkinson’s disease. If you have Parkinson’s disease and use a dose of EpiPen, you may notice your Parkinson’s symptoms worsen for a short time afterward. Because there aren’t other treatments for life threatening allergic reactions, doctors still typically prescribe EpiPen to people with Parkinson’s disease.
Overactive thyroid. People with an overactive thyroid who use EpiPen have a higher risk of side effects, including tremor and vomiting. Because there aren’t other treatments for life threatening allergic reactions, doctors still typically prescribe EpiPen to people with this condition.
Pregnancy. EpiPen contains epinephrine, which is the preferred treatment for severe allergic reactions, including in pregnant people.
Breastfeeding. EpiPen contains epinephrine, which is the preferred treatment for severe allergic reactions, including in people who are breastfeeding.
Allergic reaction. If you’ve had an allergic reaction to EpiPen or any of its ingredients, your doctor will likely not prescribe EpiPen. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Taking certain steps can help you avoid interactions with EpiPen. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- Whether you drink alcohol or use cannabis.
- Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
- What to do if you start taking a new drug during your EpiPen treatment.
It’s also important to understand EpiPen’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with EpiPen, ask your pharmacist to print a copy for you.)
If you have difficulty reading or understanding this information, your doctor or pharmacist can help.
Using EpiPen exactly as prescribed can also help prevent interactions.
If you still have questions about EpiPen and its possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Are there specific symptoms I should watch for after using EpiPen, based on my health history?
- Do I need to tell you if I start taking another medication or supplement if I’m also prescribed EpiPen?
- Could I still use EpiPen even if it interacts with a health condition I have?
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
Article source and credits to https://www.healthline.com/health/drugs/epipen-interactions