Posted by Larry Hoover on February 21, 2008, at 9:56:08
In reply to Re: Emsam, Allergy Shots, Albuterol, Xopenex, posted by HSP Woman on February 16, 2008, at 19:14:02
> Hi Lar,
>
> I am just guessing about the contraindication coming from the potential use of the epi pen. Have you read somewhere this is indeed the reason immunotherapy and MAOi's are contraindicated?No. From my knowledge of biochemistry, it is a perfectly sensible answer.
> What is it that happens when people on MAOi's are given epinephrine? Is a hypertensive crisis that cannot be mediated?Yes. That would be expected. I suppose that a much reduced dose might prove appropriate, but in an anaphylactic emergency, getting just a minimal epinephrine dose would be expecting a lot from the caregivers involved.
In a risk/benefit analysis, risking fatal anaphylaxis and/or fatal hypertension seems hardly worth the benefit of reducing allergic response to any allergen I can think of.
> I did read that exact paragraph about the use of Albuterol-like meds and MAOi's. Thanks for pointing it out though.
>
> But, I did a search for "albuterol and MAOi's" on this site (when I accidently took a dose of albuterol instead of Flovent). I recall reading a few posts from people writing that they took Albuterol (or another beta-2 agonists) and a MAOi.
>
> For example - a post I found -- "I have taken both Nardil and Emsam long-term with asthma. The main concern was the albuterol inhaler, but neither my doctor nor pharmacist had any real concerns. I never had a problem, and I use the albuterol heavily."Here's the thing.....collections of individual experiences provide statistical guidance for risk/benefit analyses. They do not allow one to predict individual experience. Just because other people got away with it, doesn't mean you will. Individals live in a binary world. You get the adverse reaction, or you don't. Statistics/probabilities don't predict binary outcomes.
Is the risk of vascular effects worth the benefit from the albuterol? Is there another way to manage your asthma?> I also recall reading that not all beta-2 agonists are created equal in the eyes of MAOi's. Some are potentiating, some are not.
If you have specific alternatives in mind, I can look at those.....I don't have specific knowledge to advise here.
> I was just hoping for more clarification from people who use it (or chose not to).
>
> The one time I took it by accident (and I am on the 6 mg patch), I monitored my blood pressure for hours afterwards. No change.
>
> Interesting...That's comforting, I suppose. The adverse effects can include rhythm disturbances, which wouldn't be found by monitoring only blood pressure. It's up to you, if you want to combine them.
> Thanks, Lar, for replying. I appreciate it a lot.You're welcome.
Lar
poster:Larry Hoover
thread:812997
URL: http://www.dr-bob.org/babble/20080221/msgs/813894.html