Research Article| Volume 59, ISSUE 6, P565-571, June 1985

Drug interactions and vasoconstrictors used in local anesthetic solutions

      This paper is only available as a PDF. To read, Please Download here.


      This study examined widely advertised interactions between sympathomimetic amine vasoconstrictors currently used in dental local anesthetic solutions and MAO inhibitors (phenelzine, 5 mg/kg), phenothiazines (chlorpromazine, 2 mg/kg), and tricyclic antidepressants (desipramine, 2 mg/kg). Twelve greyhound dogs premedicated with morphine and anesthetized with urethane and α-chloralose were prepared for physiologic recordings. During a control period, the dogs received bolus injections of epinephrine, norepinephrine, and levonordefrin sufficient to construct log-linear dose-response curves for each agent. Commercial anesthetic solutions, with and without the vasoconstrictors, were also used. The dose-response curves were then reproduced 1 hour after the administration of a drug interactant. Cardiovascular responses were not influenced by the coadministration of local anesthetics or by the prior administration of phenelzine. Chlorpromazine ameliorated pressor responses to norepinephrine and levonordephrin and reversed the hypertensive effect of high-dose epinephrine. Desipramine significantly increased vasoconstrictor potencies, particulary those of levonordefrin and norepinephrine, which were multiplied more than sixfold.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      1. Discover the risk (advertisement). Cook-Waite Laboratories, Inc, New York1977
      2. Physicians' Desk Reference. ed. 38. Medical Economics Company, Inc, Oradell, N.J1984: 617
        • Newcomb GM
        Contraindications to the use of catecholamine vasoconstrictors in dental local analgesics.
        N Z Dent J. 1973; 69: 25-30
        • Cawson RA
        • Curson I
        • Whittington DR
        The hazards of dental local anaesthetics.
        Br Dent J. 1983; 154: 253-258
        • Jastak JT
        • Yagiela JA
        Vasoconstrictors and local anesthesia: a review and rationale for use.
        J Am Dent Assoc. 1983; 107: 623-630
        • Hansten PD
        Drug interactions affecting the cardiovascular response to sympathomimetics.
        Drug Interaction Newsletter. 1981; 1: 21-26
        • Svedmyr N
        The influence of a tricyclic antidepressant agent (protriptyline) on some of the circulatory effects of noradrenaline and adrenaline in man.
        Life Sci. 1968; 7: 77-84
        • Boakes AJ
        • Laurence DR
        • Teoh PC
        • Barar FSK
        • Benedikter LT
        • Prichard BNC
        Interaction between sympathomimetic amines and antidepressant agents in man.
        Br Med J. 1973; 1: 311-315
        • Horwitz D
        • Goldberg LI
        • Sjoerdsma A
        Increased blood pressure responses to dopamine and norepinephrine produced by monoamine oxidase inhibitors in man.
        J Lab Clin Med. 1960; 56: 747-753
        • Elis J
        • Laurence DR
        • Mattie H
        • Prichard BNC
        Modification by monoamine oxidase inhibitors of the effect of some sympathomimetics on blood pressure.
        Br Med J. 1967; 2: 75-78
      3. Neidle EA Kroeger DC Yagiela JA Pharmacology and therapeutics for dentistry. The C. V. Mosby Company, St. Louis1980: 274
        • Alvarez-Mena SC
        • Frank MJ
        Phenothiazine-induced T-wave abnormalities.
        JAMA. 1973; 224: 1730-1733
        • Goldman V
        • Astrom A
        • Evers H
        A study of the interaction between a tricyclic antidepressant and some local anaesthetic solutions containing vasoconstrictors.
        J Hosp Dent Pract. 1971; 5: 176-182
      4. Catecholamines: handbook of experimental pharmacology. vol. 33. Springer-Verlag, Berlin1972: 197-200
      5. ed. 4. Catecholamines: handbook of experimental pharmacology. vol. 33. Springer-Verlag, Berlin1972: 207-208
        • Persson G
        • Siwers B
        The risk of potentiating effect of local anaesthesia with adrenalin in patients treated with tricyclic antidepressants.
        Sven Tandlak Tidskr. 1975; 68: 9-18
      6. J Am Dent Assoc. 1955; 50: 108