What interactions are common for bupivacaine HCI and epinephrine injection?

Bupivacaine-epinephrine injection should not be combined with monoamine oxidase inhibitors or tricyclic antidepressants as this can lead to severe and ongoing hypertension (high blood pressure). In addition, dangerously irregular heartbeats may occur if this injection is used in someone who is -- or was recently -- on chloroform, halothane, cyclopropane, trichloroethylene or similar anesthetics. If sedatives are being used to reduce anxiety during a medical procedure, a reduced dose of bupivacaine-epinephrine injection should be given to avoid the addictive effect of this combination.

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