Severe epinephrine-propranolol interaction.

A 53-year-old man presented to the emergency department with posterior pharyngeal edema. He had taken a long-acting propranolol product the previous evening that had been prescribed for migraine headaches. After administration of epinephrine subcutaneously in the ED, he developed a severe adverse reaction, characterized by profound hypertension and bradycardia. This potentially serious drug interaction is described, and relevant literature is reviewed.