Drug interactions
Benzhydrocodone / acetaminophen + Tranylcypromine
Severity: Major
Benzhydrocodone / acetaminophen and Tranylcypromine: major interaction.
Last updated Sources: US FDA label
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
Benzhydrocodone is a prodrug of hydrocodone, and use with MAOIs can lead to serotonin syndrome or opioid toxicity including respiratory depression, coma and hypotension. Labeling advises against use during or within 14 days of MAOI therapy.
What this interaction means in plain words
Benzhydrocodone / acetaminophen and Tranylcypromine 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
MAO inhibition increases serotonergic activity and can potentiate opioid CNS and respiratory depression.
What to do
Avoid the combination and do not start the opioid within 14 days of stopping tranylcypromine. If urgent opioid treatment is required, use small test doses with careful titration and monitor blood pressure, sedation, respiration and serotonin toxicity signs.
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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References
Other interactions of Tranylcypromine
- 5-HTP + Tranylcypromine Contraindicated
- Amitriptyline + Tranylcypromine Contraindicated
- Amoxapine + Tranylcypromine Contraindicated
- Atomoxetine + Tranylcypromine Contraindicated
- Benzphetamine + Tranylcypromine Contraindicated
- Brimonidine + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Benzhydrocodone / acetaminophen with Tranylcypromine?
MediHelp rates the interaction as major. Benzhydrocodone / acetaminophen and Tranylcypromine 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. Benzhydrocodone is a prodrug of hydrocodone, and use with MAOIs can lead to serotonin syndrome or opioid toxicity including respiratory depression, coma and hypotension. Labeling advises against use during or within 14 days of MAOI therapy.
How serious is the interaction between Benzhydrocodone / acetaminophen and Tranylcypromine?
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 do not start the opioid within 14 days of stopping tranylcypromine. If urgent opioid treatment is required, use small test doses with careful titration and monitor blood pressure, sedation, respiration and serotonin toxicity signs.
What other medicines interact with Tranylcypromine?
MediHelp also lists interactions of Tranylcypromine with, for example, 5-HTP, Amitriptyline, Amoxapine. The full list is on the Tranylcypromine page.
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