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Drug reference

Metaraminol

Sympathomimetic · Vasopressor

SympathomimeticVasopressorATC C01CA04
CDSCO approvedSchedule HATC C01CA04
EXCRETION
—
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
May reduce placental perfusion—manufacturer advises use only if potential benefit outweighs risk.
FDA category + note
Top interactionssee all 12 →
  • AmitriptylineSevereDatabaseDDInter
  • AmoxapineSevereDatabaseDDInter
  • ClomipramineSevereDatabaseDDInter
  • DesipramineSevereDatabaseDDInter

Mechanism

Metaraminol is a direct-acting sympathomimetic amine. It primarily exerts its effects by activating alpha-adrenergic receptors, leading to widespread vasoconstriction. This action results in an increase in systemic vascular resistance and subsequently, blood pressure, making it useful as a pressor agent.

Indications

Emergency treatment of acute hypotensionAcute hypotensionhypotensive statesparoxysmal atrial tachycardia (off-label, especially if associated with hypotension)

Dosing

Adult
Emergency treatment of acute hypotension: Initially 0.5–5 mg by intravenous injection, then 15–100 mg by intravenous infusion, adjusted according to response. Acute hypotension: 15–100 mg by intravenous infusion, adjusted according to response.

Contraindications

  • Cirrhosis
  • Coronary vascular thrombosis
  • Diabetes mellitus
  • Extravasation at injection site may cause necrosis
  • Following myocardial infarction
  • Hypercapnia
  • Hypertension
  • Hyperthyroidism
  • Hypoxia
  • Mesenteric vascular thrombosis
  • Peripheral vascular thrombosis
  • Prinzmetal’s variant angina
  • Uncorrected hypovolaemia

Side effects

Common
HeadacheHypertensionNauseaPalpitations
Serious
  • Skin exfoliation
  • Soft tissue necrosis
  • Abscess
  • Arrhythmias
  • Peripheral ischaemia
  • Angina pectoris
  • Anxiety
  • Azotaemia
  • Cardiac conduction disorder
  • Dyspnoea
  • Gangrene
  • Mydriasis
  • Piloerection
  • Polyuria
  • Tremor
  • Vasoconstriction
  • Vomiting

Pregnancy & lactation

Pregnancy

May reduce placental perfusion—manufacturer advises use only if potential benefit outweighs risk.

Lactation

Manufacturer advises caution—no information available.

Drug interactions

Amitriptyline
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Amoxapine
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Clomipramine
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Desipramine
Severe
Database

Clinical effect not specified

Source: DDInter

Dihydroergotamine
Severe
Database

Clinical effect not specified

Source: DDInter

Doxepin
Severe
Database

Clinical effect not specified

Source: DDInter

Ergotamine Tartrate
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Imipramine
Severe
Database

Clinical effect not specified

Source: DDInter

Isocarboxazid
Severe
Database

Clinical effect not specified

Source: DDInter

Linezolid
Severe
Database

Clinical effect not specified

Source: DDInter

Methylene Blue
Severe
Database

Clinical effect not specified

Source: DDInter

Methylergometrine
Severe
Database

Clinical effect not specified

Source: DDInter

Related guidelines

Other Sympathomimetic drugs

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Textbook-sourced·Sources: Goodman & Gilman 14e, Katzung, BNF·Updated: 2026-05-10