Drug & supplement interaction

Beta-hydroxybutyrate (bhb) + Epinephrine Injection

Epinephrine Injection brand name: Twinject.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Beta-hydroxybutyrate (bhb) and Epinephrine Injection in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Beta-hydroxybutyrate (bhb) and Epinephrine Injection

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Epinephrine Injection and Beta-hydroxybutyrate (bhb) in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Beta-hydroxybutyrate (bhb) at all — not against Epinephrine Injection, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Beta-hydroxybutyrate (bhb) safety at a glance

Beta-hydroxybutyra... overall Use caution Generally tolerated short-term but may cause stomach upset and adds significant minerals or sodium; long-term safety is not well studied.
Pregnancy Avoid Not enough safety data; avoid during pregnancy unless your doctor advises otherwise.
Breastfeeding Avoid Not enough safety data; best to avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Epinephrine Injection and Beta-hydroxybutyrate (bhb)? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Beta-hydroxybutyrate (bhb) and Epinephrine Injection May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Vomiting / Nausea Additional detail

    Beta-hydroxybutyrate (bhb)

    “Orally, BHB may cause indigestion, diarrhea, nausea, gastrointestinal upset, and vomiting in some patients. In a small crossover study, nausea, diarrhea, and vomiting were reported in 37%, 16%, and 11% of patients, respectively, taking two 0.38 gram/kg doses of BHB salts separated by 45 minutes on a single day.”

    Beta-hydroxybutyrate (bhb) · Natural Medicines adverse-effect record, reported in constipation.

    4 sources cited
    1. 96084. Gautschi M, Weisstanner C, Slotboom J, Nava E, Zürcher T, Nuoffer JM. Highly efficient ketone body treatment in multiple acyl-CoA dehydrogenase deficiency-related leukodystrophy. Pediatr Res. 2015;77(1-1):91-8. PubMed
    2. 96096. Gross EC, Sandor P, Fischer D. Preliminary data on exogenous ketone bodies in migraine prevention. Cephalalgia 2017; 37(1S) 52-171.
    3. 102024. Evans M, Patchett E, Nally R, Kearns R, Larney M, Egan B. Effect of acute ingestion of β-hydroxybutyrate salts on the response to graded exercise in trained cyclists. Eur J Sport Sci. 2018;18(3):376-86.
    4. 96088. Clarke K, Tchabanenko K, Pawlosky R, et al. Kinetics, safety and tolerability of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate in healthy adult subjects. Regul Toxicol Pharmacol. 2012;63(3):401-8. PubMed

    Epinephrine Injection

    Listed in the ADVERSE REACTIONS section of the FDA label for Epinephrine Injection. Read the label on DailyMed ›

Reported for Beta-hydroxybutyrate (bhb) but not commonly for Epinephrine Injection: stomach upset, stomach pain, constipation and dehydration.

Effects for Epinephrine Injection come from the ADVERSE REACTIONS section of its FDA label; effects for Beta-hydroxybutyrate (bhb) come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Everything else you take

See Every Supplement That Interacts With Epinephrine Injection

This page covers Beta-hydroxybutyrate (bhb) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Epinephrine Injection page lists 1 supplement it has a documented interaction with, worst first, each one explained.

The most serious there right now: Butcher's Broom (moderate).

By severity: 1 moderate.

From our pharmacist’s overview on the Epinephrine Injection page

“For anyone carrying an epinephrine injection like Twinject for severe allergic reactions, the supplement interaction list is remarkably short. Just one ingredient is on file, butcher's broom, and it rates moderate.”

Reviewed by 2 · Jul 18, 2026

Open the Epinephrine Injection interaction page

How much people look this up

Where Beta-hydroxybutyrate (bhb) and Epinephrine Injection Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Beta-hydroxybutyrate (bhb)
Steady interest

#1,324 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Epinephrine Injection
Top half

#908 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Beta-hydroxybutyrate (bhb) reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Beta-hydroxybutyrate (bhb) and Epinephrine Injection records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Beta-hydroxybutyrate (bhb)

What is Beta-hydroxybutyrate (bhb)?

Beta-hydroxybutyrate (bhb)
  • Weight loss and fat burning
  • Boosting energy on a ketogenic diet
  • Athletic and exercise performance
  • Mental focus and clarity
  • Reducing 'keto flu' symptoms

Beta-hydroxybutyrate (BHB) is a ketone body your liver naturally makes when carbs are low, and it is sold as a supplement marketed for weight loss, energy, and athletic performance. Despite bold marketing claims, human evidence that BHB supplements help with weight loss or performance is limited and mixed. If you want to try it, talk with your pharmacist or doctor first, especially if you have kidney, heart, or blood pressure concerns.

Not applicable (a ketone body made by the body or produced as a synthetic salt) · Capsules, powders, drink mixes (often as BHB salts bound to sodium, calcium, magnesium, or potassium; also BHB esters)

An interaction check asks whether these two react with each other — it does not ask whether Beta-hydroxybutyrate (bhb) is a good idea for someone in your situation. Here is what our Beta-hydroxybutyrate (bhb) record says about it on its own.

Beta-hydroxybutyrate (bhb): dosing

There is no official, standardized dose of BHB. Products vary widely in how much BHB they contain and which minerals they are paired with.The best approach is to follow the directions on the product label and not exceed them. Many people start with a smaller amount to see how their stomach reacts before using more.Because mineral content matters, check how much sodium, calcium, magnesium, or potassium each serving provides.

From our Beta-hydroxybutyrate (bhb) monograph — the full record covers uses, side effects and every documented interaction.

Read the full Beta-hydroxybutyrate (bhb) monograph & all interactions
Medication

About Epinephrine Injection

What Is Epinephrine Injection Used For?

Brand name: Twinject

Epinephrine injection is used for the emergency treatment of anaphylaxis — a severe, potentially life-threatening allergic reaction. Triggers can include stings from bees, wasps, hornets, yellow jackets, and fire ants; bites from insects like mosquitoes; foods; drugs; diagnostic agents; allergen immunotherapy; or exercise. It is also used for anaphylaxis with no identified trigger (idiopathic anaphylaxis).

AUVI-Q (available in 0.3 mg and 0.15 mg strengths) is specifically indicated for patients at increased risk of anaphylaxis, including those with a history of anaphylactic reactions. It is intended for immediate emergency use only — not as a substitute for follow-up medical care.

See full Epinephrine Injection drug information
Keep checking

Other Drugs & Beta-hydroxybutyrate (bhb)

Browse every other medication we’ve checked against Beta-hydroxybutyrate (bhb) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

We also checked Beta-hydroxybutyrate (bhb) against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Beta-hydroxybutyrate (bhb) list.

See the full Beta-hydroxybutyrate (bhb) interactions page
See every supplement checked against Epinephrine Injection, ranked by severity
Evidence & sources

Beta-hydroxybutyrate (bhb) References

The 6 references that drive our Beta-hydroxybutyrate (bhb) monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Gautschi M, Weisstanner C, Slotboom J, Nava E, Zürcher T, Nuoffer JM. Highly efficient ketone body treatment in multiple acyl-CoA dehydrogenase deficiency-related leukodystrophy. Pediatr Res. 2015;77(1-1):91-8. PubMed
  2. Van Rijt WJ, Heiner-Fokkema MR, du Marchie Sarvaas GJ, et al. Favorable outcome after physiologic dose of sodium-D,L-3-hydroxybutyrate in severe MADD. Pediatrics. 2014;134(4):e1224-8.
  3. Clarke K, Tchabanenko K, Pawlosky R, et al. Kinetics, safety and tolerability of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate in healthy adult subjects. Regul Toxicol Pharmacol. 2012;63(3):401-8. PubMed
  4. Gross EC, Sandor P, Fischer D. Preliminary data on exogenous ketone bodies in migraine prevention. Cephalalgia 2017; 37(1S) 52-171.
  5. Evans M, Patchett E, Nally R, Kearns R, Larney M, Egan B. Effect of acute ingestion of β-hydroxybutyrate salts on the response to graded exercise in trained cyclists. Eur J Sport Sci. 2018;18(3):376-86.
  6. Malhi MS, Duerson F, Salabei JK, Okonoboh P. Starvation Ketoacidosis Induced by Ketogenic Diet and Consumption of Ketone Supplement. Cureus. 2021;13(6):e15778. Published 2021 Jun 20. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Beta-hydroxybutyrate (bhb) and Epinephrine Injection Together: Common Questions

Is it safe to take Beta-hydroxybutyrate (bhb) with Epinephrine Injection?
We do not list a known interaction between Beta-hydroxybutyrate (bhb) and Epinephrine Injection. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Beta-hydroxybutyrate (bhb) and Epinephrine Injection have any of the same side effects?
Yes — our sources link each of them separately to 2 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Does Epinephrine Injection interact with any supplements?
Yes. Epinephrine Injection has documented interactions with 1 supplement in our database — Beta-hydroxybutyrate (bhb) is not one of them. The Epinephrine Injection interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Beta-hydroxybutyrate (bhb) monograph Uses, safety profile, and every drug interaction in one place Epinephrine Injection drug information The full plain-English guide to this medication Epinephrine Injection supplement interactions Every supplement checked against Epinephrine Injection, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 6 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Epinephrine Injection and Beta-hydroxybutyrate (bhb)?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.