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**Cafedrine + theodrenaline** is a fixed-dose 20:1 small-molecule sympathomimetic combination marketed as **Akrinor**. Cafedrine is a covalent norephedrine-theophylline conjugate and theodrenaline is a covalent noradrenaline-theophylline conjugate. The combination is used in adults to treat clinically relevant hypotension associated with anesthesia and hypotensive states in emergency medicine. Its pressor effect is driven predominantly by beta-1 adrenergic stimulation, increasing cardiac preload, stroke volume, and cardiac output to raise mean arterial pressure, generally without marked tachycardia or a major increase in systemic vascular resistance. The product was originated by AWD.pharma and is currently marketed in Germany by ratiopharm as an injectable solution.
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