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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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Sources: Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-10 · House clinical team