Drug Interaction Report

Epinephrine and Methylergonovine: Interaction Details

A pharmacist-reviewed analysis of the Epinephrine and Methylergonovine interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Methylergonovine

Methergine Methergine® Methylergometrine
+

Epinephrine

No brand names on record
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 31 documented Epinephrine interactions, 27 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Reversed pressor effects of EPINEPHrine, an increased risk of hypertension or an increased risk of cerebrovascular accidents

Interaction Deep Dive

Avoid coadministration of EPINEPHrine and methylergonovine (an ergot derivative) as it may cause severe, persistent hypertension or cerebrovascular accidents1, and may also reverse the pressor effects of EPINEPHrine 2. Carefully monitor blood pressure in patients who receive both agents 34.

Why it happens (mechanism)

Unknown

Common questions

Can I take Epinephrine and Methylergonovine together?

Reversed pressor effects of EPINEPHrine, an increased risk of hypertension or an increased risk of cerebrovascular accidents Always confirm with your pharmacist or prescriber before making any change.

How serious is the Epinephrine and Methylergonovine interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Epinephrine or Methylergonovine need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (4)

  1. Product Information: FLAVALTA injection solution, lidocaine hydrochloride and epinephrine injection solution. SEPTODONT Inc. Lancaster, PA, 2026. DailyMed
  2. Product Information: NEFFY(R) nasal spray, epinephrine nasal spray. ARS Pharmaceuticals Operations, Inc. (per FDA), San Diego, CA, 2024. DailyMed
  3. Product Information: CORPHEDRA(TM) IV Injection, ephedrine sulfate IV injection. Par Pharmaceutical (per FDA), Chestnut Ridge, NY, 2017.
  4. Product Information: AKOVAZ(TM) intravenous injection, ephedrine sulfate intravenous injection. Eclat Pharmaceuticals (per FDA), Chesterfield, MO, 2016. DailyMed
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Methylergonovine

Keep reading about Methylergonovine

All Methylergonovine interactions (226) Methylergonovine drug information
Also serious with: Almotriptan Dihydroergotamine Injection Atazanavir Dinoprostone
Epinephrine

Keep reading about Epinephrine

All Epinephrine interactions (31) Epinephrine drug information
Also serious with: Dihydroergotamine Injection Dihydroergotamine Nasal Spray Linezolid Injection Levothyroxine
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Epinephrine + Activated Charcoal Butcher's Broom Coffee Charcoal European Mandrake Glucomannan Guar Gum Gum Arabic Slippery Elm + 10 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.