Drug interactions
Benzhydrocodone / acetaminophen + Selegiline
Severity: Major
Benzhydrocodone / acetaminophen and Selegiline: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
MAO inhibitors combined with opioids can cause serotonin syndrome or severe opioid toxicity with respiratory depression and coma. Labeling advises against opioid use during or within 14 days after MAOI therapy. Oral low-dose selegiline is selective for MAO-B but selectivity is lost at higher doses and with transdermal use.
What this interaction means in plain words
Benzhydrocodone / acetaminophen and Selegiline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Serotonergic potentiation and unpredictable enhancement of opioid effects with MAO inhibition.
What to do
Avoid the combination and use a non-opioid analgesic where possible. If an opioid is essential, use small titrated doses with close monitoring of CNS, respiratory status and blood pressure.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Selegiline
- Amitriptyline + Selegiline Contraindicated
- Amoxapine + Selegiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
- Benzphetamine + Selegiline Contraindicated
- Brimonidine + Selegiline Contraindicated
- Buprenorphine long-acting + Selegiline Contraindicated
Frequently asked questions
Can I take Benzhydrocodone / acetaminophen with Selegiline?
MediHelp rates the interaction as major. Benzhydrocodone / acetaminophen and Selegiline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. MAO inhibitors combined with opioids can cause serotonin syndrome or severe opioid toxicity with respiratory depression and coma. Labeling advises against opioid use during or within 14 days after MAOI therapy. Oral low-dose selegiline is selective for MAO-B but selectivity is lost at higher doses and with transdermal use.
How serious is the interaction between Benzhydrocodone / acetaminophen and Selegiline?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use a non-opioid analgesic where possible. If an opioid is essential, use small titrated doses with close monitoring of CNS, respiratory status and blood pressure.
What other medicines interact with Selegiline?
MediHelp also lists interactions of Selegiline with, for example, Amitriptyline, Amoxapine, Atomoxetine. The full list is on the Selegiline page.
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