Norfine Drug Interactions

Inadvisable Combinations: Volatile Halogenated Anaesthetics: severe ventricular arrhythmia (increase in cardiac excitability).
Imipramine Antidepressants: paroxysmal hypertension with the possibility of arrhythmia (inhibition of the entry of sympathomimetics into sympathetic fibres).
Serotoninergic-Adrenergic Antidepressants: paroxysmal hypertension with the possibility of arrhythmia (inhibition of the entry of sympathomimetics into sympathetic fibres).
Digitalis Glycosides.
Levodopa.
Chlorpheniramine Hydrochloride, Tripelennamine Hydrochloride and Desipramine: significantly increase the toxicity of Norepinephrine.
Antihistamines, as some may block the intake of atecholamines by peripheral tissues and increase the toxicity of injected Norepinephrine.
The use of pressor amines with cyclopropane, halothane, chloroform, enflurane or other halogenated anaesthetics may cause serious cardiac arrhythmias, because of the possibility of increasing the risk of ventricular fibrillation, Norepinephrine should be used with caution in patients receiving these or any other cardiac sensitising agent or who exhibit profound hypoxia or hypercarbia.
Combinations requiring Precautions for Use: Non-Selective Monoamine Oxidase (MAO) Inhibitors: increase in the pressor action of the sympathomimetic which is usually moderate. Should only be used under close medical supervision.
Selective MAO-A Inhibitors: by extrapolation from non-selective MAO inhibitors, risk of increase in the pressor action. Should only be used under close medical supervision.
Linezolid: by extrapolation from non-selective MAO inhibitors: risk of increase in the pressor action. Should only be used under close medical supervision.
Norepinephrine should be used with extreme caution in patients receiving MAO inhibitors or within 14 days of cessation of such therapy.
The effects of Norepinephrine may be enhanced by guanethidine, guanadrel, reserpine, methyldopa or tricyclic antidepressants, amphetamine, doxapram, mazindol, rauwolfia alkaloids.
Caution is required when using Norepinephrine with alpha and beta blockers as severe hypertension may result.
Caution is required when using Norepinephrine with the following drugs as they may cause increased cardiac effects: thyroid hormones, cardiac glycosides, antiarrhythmic.
Ergot alkaloids (ergoloid mesylates, ergotamine, dihydroergotamine, ergometrine, methylergometrine, and methysergide) or oxytocin may enhance the vasopressor and vasoconstrictive effects.
Concomitant administration of propofol and Norepinephrine may lead to propofol infusion syndrome (PRIS).
Desmopressin or Vasopressin: its antidiuretic effect is diminished.
Lithium decreases the effect of Norepinephrine.
Norepinephrine infusion solutions should not be mixed with other medications (except those mentioned in Special Precautions for Disposal and Other Handling under Cautions for Usage).