Selected Inhalation Anesthetic Agents/Sympathomimetics Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Sympathomimetics can increase blood pressure and heart rate, which can increase the ability of anesthetics to change the rhythm of the heart.

What might happen:

You may develop an irregular heartbeat.

What you should do about this interaction:

These medicines are used during surgical procedures or in a hospital. If you are to have either inpatient or outpatient surgery, or are to be admitted to the hospital, make sure that all the healthcare professionals are aware of all the different medicines that you are taking. This includes prescription medicines, herbal drugs, and nutraceuticals.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

View Reference
  • 1.Weiner N. Norepinephrine, epinephrine, and the sympathomimetic amines. In Gilman AG, Goodman LS, Rall TW, Murad F, eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 7th ed. New York: MacMillan Publishing Company. 1985.
  • 2.Concerta (methylphenidate) Extended-Release prescribing information. Janssen Pharmaceuticals October, 2023.
  • 3.Katz RL, Matteo RS, Papper EM. The injection of epinephrine during general anesthesia with halogenated hydrocarbons and cyclopropane in man. Anesthesiology 1962 Sep Oct;23(5):597-600.
  • 4.Johnstone M. Adrenaline and noradrenaline during anaesthesia. Anaesthesia 1953;8:32-42.
  • 5.Hirshom WI, Taylor RG, Sheehan JC. Arrhythmias produced by combinations of halothane and small amounts of vasopressor. Br J Oral Surg 1965;2:131-36.
  • 6.Andersen N, Johansen SH. Incidence of catechol-amine-induced arrhythmias during halothane anesthesia. Anesthesiology 1963 Jan Feb;24(1):51-56.
  • 7.Matteo RS, Katz RL, Papper EM. The injection of epinephrine during general anesthesia. Anesthesiology 1962;23:360-64.
  • 8.Joas TA, Stevens WC. Comparison of the arrhythmic doses of epinephrine during Forane, halothane, and fluroxene anesthesia in dogs. Anesthesiology 1971 Jul;35(1):48-53.
  • 9.Wallbank WA. Cardiac effects of halothane and adrenaline in hare-lip and cleft- palate surgery. Br J Anaesth 1970 Jun;42(6):548-52.
  • 10.Melgrave AP. The use of epinephrine in the presence of halothane in children. Can Anaesth Soc J 1970 May;17(3):256-60.
  • 11.Forbes AM. Halothane, adrenaline and cardiac arrest. Anaesthesia 1966 Jan;21(1):22-7.
  • 12.Reisner LS, Lippmann M. Ventricular arrhythmias after epinephrine injection in enflurane and in halothane anesthesia. Anesth Analg 1975 Jul-Aug;54(4):468-70.
  • 13.Ikezono E, Yasuda K, Hattori Y. Effects of propranolol on epinephrine-induced arrhythmias during halothane anesthesia in man and cats. Anesth Analg 1969 Jul-Aug;48(4):598-604.
  • 14.Ueda W, Hirakawa M, Mae O. Appraisal of epinephrine administration to patients under halothane anesthesia for closure of cleft palate. Anesthesiology 1983 Jun;58(6):574-6.
  • 15.Kaufman L. Unforeseen complications encountered during dental anaesthesia. Cardiac arrhythmias during dental anaesthesia. Proc R Soc Med 1966 Aug;59(8):731-4.
  • 16.Alexander JP. Dysrhythmia and oral surgery. Br J Anaesth 1971 Aug; 43(8):773-8.
  • 17.Alexander JP, Bekheit S, Fletcher E. Dysrhythmia and oral surgery. II. Junctional rhythms. Br J Anaesth 1972 Nov;44(11):1179-82.
  • 18.Katz RL, Katz GJ. Surgical infiltration of pressor drugs and their interaction with volatile anaesthetics. Br J Anaesth 1966 Sep; 38(9):712-8.
  • 19.Thiagarajah S, Grynsztejn M, Lear E, Azar I. Ventricular arrhythmias after terbutaline administration to patients anesthetized with halothane. Anesth Analg 1986 Apr;65(4):417-8.
  • 20.Katz RL, Epstein RA. The interaction of anesthetic agents and adrenergic drugs to produce cardiac arrhythmias. Anesthesiology 1968 Jul-Aug; 29(4):763-84.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.