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Drug interactions

Buprenorphine long-acting + Tranylcypromine

Severity: Contraindicated

Buprenorphine long-acting and Tranylcypromine: contraindicated 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

Combining an MAOI with an opioid like buprenorphine can cause serotonin syndrome, and may also produce opioid toxicity with respiratory depression and coma. Because the long-acting injection cannot be quickly removed, any reaction can be prolonged.

What this interaction means in plain words

Buprenorphine long-acting and Tranylcypromine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Evidence level: Moderate

Why it happens

Serotonergic excess from MAO inhibition combined with opioid effects, plus possible enhancement of opioid CNS and respiratory depression.

What to do

Do not use the long-acting injection in patients taking an MAOI or within 14 days of stopping one. Choose a non-serotonergic alternative or wait the washout period.

What to ask your pharmacist

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Buprenorphine long-acting with Tranylcypromine?

MediHelp rates the interaction as contraindicated. Buprenorphine long-acting and Tranylcypromine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Combining an MAOI with an opioid like buprenorphine can cause serotonin syndrome, and may also produce opioid toxicity with respiratory depression and coma. Because the long-acting injection cannot be quickly removed, any reaction can be prolonged.

How serious is the interaction between Buprenorphine long-acting and Tranylcypromine?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use the long-acting injection in patients taking an MAOI or within 14 days of stopping one. Choose a non-serotonergic alternative or wait the washout period.

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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