NutriStack
Albuterol and Cocaine, contraindicated.
Cocaine and albuterol can both increase adrenergic cardiovascular stress. Cocaine can cause tachycardia, hypertension, coronary vasospasm, myocardial ischemia, and arrhythmias, while albuterol can add tachycardia, tremor, hypokalemia, and electrophysiologic changes at higher exposure. Smoked cocaine can also provoke bronchospasm, creating a dangerous cycle of airway symptoms and escalating rescue-inhaler use.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Pair type
- Contraindicated
- Evidence (highest tier)
- Moderate
- Source citations
- 4 sources
- Stack Score effect
- −25 to your Stack Score (per scored contraindication row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Contraindicated · Moderate evidence
Contraindicated
What is happening. Cocaine and albuterol can both increase adrenergic cardiovascular stress. Cocaine can cause tachycardia, hypertension, coronary vasospasm, myocardial ischemia, and arrhythmias, while albuterol can add tachycardia, tremor, hypokalemia, and electrophysiologic changes at higher exposure. Smoked cocaine can also provoke bronchospasm, creating a dangerous cycle of airway symptoms and escalating rescue-inhaler use.
Mechanism. Albuterol stimulates beta-2 adrenergic receptors and can produce beta-mediated cardiac stimulation and intracellular potassium shift. Cocaine blocks norepinephrine reuptake, increases sympathetic outflow, causes vasoconstriction, and has sodium-channel blocking effects, creating additive arrhythmia and ischemia risk.
Recommendation. Do not use cocaine while using albuterol. If cocaine exposure occurs, do not keep repeating albuterol for chest tightness without medical assessment, because symptoms may reflect bronchospasm, ischemia, panic, or arrhythmia. Seek emergency care for chest pain, severe shortness of breath, fainting, severe agitation, or a fast or irregular heartbeat.
Sources (4)
- Ahrens RC, Smith GD. Albuterol: an adrenergic agent for use in the treatment of asthma pharmacology, pharmacokinetics and clinical use. Pharmacotherapy. 1984;4(3):105-121. PMID 6739311
- Vongpatanasin W, Mansour Y, Chavoshan B, Arbique D, Victor RG. Cocaine stimulates the human cardiovascular system via a central mechanism of action. Circulation. 1999;100(5):497-502. PMID 10430763
- Billman GE. Cocaine: a review of its toxic actions on cardiac function. Crit Rev Toxicol. 1995;25(2):113-132. PMID 7612173
- Tashkin DP, Kleerup EC, Koyal SN, Marques JA, Goldman MD. Acute effects of inhaled and i.v. cocaine on airway dynamics. Chest. 1996;110(4):904-910. PMID 8874243
Stack Score
How this pair moves the number.
Effect on the composite score
If both Albuterol and Cocaine are in the same stack, this pair applies −25 to your Stack Score (per scored contraindication row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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