Monoamine oxidase inhibitors (phenelzine, isocarboxazid), clonidine , selegiline , guanethidine, and ergotamines (ergotamine tartrate, dihydroergotamine mesylate) may increase blood pressure when used at the same time as ephedrine. Methyldopa or reserpine may reduce ephedrine levels in the blood and thereby lessen the effectiveness of ephedrine. Tricyclic antidepressants ( desipramine , amitriptyline , doxepin , and imipramine ) may block the effect of ephedrine. The carbonic anhydrase inhibitors acetazolamide and dichlorphenamide may increase ephedrine blood levels and the risk of side effects from ephedrine. Patients taking any medications should consult with their physician or pharmacist before starting OTC ephedrine.
Nebulisers are machines that turn the liquid form of your short-acting bronchodilator medicines into a fine mist, like an aerosol. You breathe this in with a face mask or a mouthpiece. Nebulisers are no more effective than normal inhalers. However, they are extremely useful in people who are very tired (fatigued) with their breathing, or people who are very breathless. Nebulisers are used mainly in hospital for severe attacks of COPD when large doses of inhaled medicines are needed. They are used less commonly than in the past, as modern spacer devices are usually just as good as nebulisers for giving large doses of inhaled medicines. You do not need any co-ordination to use a nebuliser - you just breathe in and out, and you will breathe the medicine in.