Propranolol-epinephrine interaction: a potential disaster

Plast Reconstr Surg. 1983 Jul;72(1):74-8. doi: 10.1097/00006534-198307000-00017.


Presented here are six examples of potentially life-threatening propranolol-epinephrine interactions. The only report found that warns of a deleterious clinical interaction between propranolol and epinephrine appeared in 1980. With widespread use of propranolol for approved and unapproved conditions, the population at risk is significant. All physicians and dentists using local anesthetic with epinephrine should be aware of this interaction.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autonomic Nervous System / physiology
  • Bradycardia / chemically induced
  • Cardiovascular Physiological Phenomena
  • Drug Interactions
  • Epinephrine / adverse effects*
  • Female
  • Humans
  • Hypertension / chemically induced*
  • Kinetics
  • Male
  • Middle Aged
  • Propranolol / adverse effects*
  • Propranolol / metabolism


  • Propranolol
  • Epinephrine