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EpiPen JR 2-Pak and Milnacipran Hydrochloride

Determining the interaction of EpiPen JR 2-Pak and Milnacipran Hydrochloride and the possibility of their joint administration.

Check result:

EpiPen JR 2-Pak <> Milnacipran Hydrochloride

Relevance: 21.06.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Both EPINEPHrine and milnacipran can increase blood pressure and heart rate, and combining them may enhance these effects. Talk to your doctor if you have any questions or concerns, particularly if you have a history of high blood pressure, irregular heart rhythm, or heart disease. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Additive or synergistic effects on blood pressure and heart rate may occur when serotonin-norepinephrine reuptake inhibitors (SNRIs) such as milnacipran are combined with the sympathomimetic agents norepinephrine or epinephrine. The proposed mechanism is increased noradrenergic response due to SNRI-mediated inhibition of the reuptake of these sympathomimetics into the sympathetic nerve fibre. The use of milnacipran alone has also been associated with rare cases of sustained tachycardia, hypertension, and reversible cardiomyopathy requiring treatment discontinuation.

MANAGEMENT: Caution is advised if SNRIs are used with other drugs that can increase blood pressure and/or heart rate. Blood pressure and pulse should be measured prior to initiating SNRI therapy and monitored at regular intervals thereafter. Dose reduction or discontinuation of the SNRI should be considered in patients who experience a sustained increase in blood pressure or pulse rate. Some authorities advise that if the hemostatic action of epinephrine via subcutaneous or gingival injection is needed in adults, an epinephrine dose of less than 0.1 mg in 10 minutes or 0.3 mg in an hour may be considered.

References

"Product Information. Savella (milnacipran)." Forest Pharmaceuticals, St. Louis, MO.
Yoshida K, Higuchi H, Takahashi H, Shimizu T "Elevation of blood pressure induced by high-dose milnacipran." Hum Psychopharmacol 17 (2002): 431
Forman MB, Sutej PG, Jackson EK "Hypertension, tachycardia, and reversible cardiomyopathy temporally associated with milnacipran use." Tex Heart Inst J 38 (2011): 714-8
Palmer RH, Periclou A, Banerjee P "Milnacipran: a selective serotonin and norepinephrine dual reuptake inhibitor for the management of fibromyalgia " Ther Adv Musculoskelet Dis 2 (2010): 201-20
Cerner Multum, Inc. "Australian Product Information." O 0

EpiPen JR 2-Pak

Generic Name: epinephrine

Brand name: Adrenalin, Auvi-Q, Epinephrinesnap-EMS, EpiPen 2-Pak, EpiPen JR 2-Pak, EPIsnap, Symjepi, Auvi-Q Auto-injector, Primatene Mist Inhaler, Adrenaclick, EpiPen, Twinject, Primatene Mist

Synonyms: n.a.

What is EpiPen JR 2-Pak?

Milnacipran Hydrochloride

Generic Name: milnacipran

Brand name: Savella, Savella Titration Pack

Synonyms: Milnacipran

What is Milnacipran Hydrochloride?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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