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Epinephrine + phenylephrine is a combination of two sympathomimetic agents, both acting as vasopressors and decongestants. Epinephrine (also known as adrenaline) is a non-selective adrenergic agonist that stimulates alpha- and beta-adrenergic receptors, leading to increased heart rate, bronchodilation, vasoconstriction, and elevated blood pressure. It is widely used in emergency medicine for anaphylaxis, cardiac arrest, severe asthma exacerbations, and as an adjunct to local anesthetics to prolong their effect[6]. Phenylephrine is a selective alpha-1 adrenergic receptor agonist with minimal beta-adrenergic activity; it primarily causes vasoconstriction of blood vessels resulting in increased blood pressure and reduced nasal congestion[5][7][10]. The combination may be considered for situations requiring potent vasopressor effects or enhanced decongestant action but should be used with caution due to the risk of excessive hypertension or cardiovascular stimulation[2].
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