Drug interactions
Buprenorphine subdermal implant + Tranylcypromine
Severity: Major
Buprenorphine subdermal implant 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
Combining an MAO inhibitor with an opioid such as buprenorphine can cause serotonin toxicity or other severe reactions including CNS excitation or depression. Risk with buprenorphine is lower than with some other opioids, but irreversible MAO inhibition makes the combination hazardous.
What this interaction means in plain words
Buprenorphine subdermal implant 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
Irreversible MAO inhibition combined with opioid effects may increase serotonergic activity and additive CNS effects.
What to do
Avoid buprenorphine during and within 14 days of MAO inhibitor therapy where possible. If it is essential, monitor closely for agitation, hyperthermia, clonus and autonomic instability and stop the opioid if serotonin syndrome is suspected.
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 Buprenorphine subdermal implant with Tranylcypromine?
MediHelp rates the interaction as major. Buprenorphine subdermal implant 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. Combining an MAO inhibitor with an opioid such as buprenorphine can cause serotonin toxicity or other severe reactions including CNS excitation or depression. Risk with buprenorphine is lower than with some other opioids, but irreversible MAO inhibition makes the combination hazardous.
How serious is the interaction between Buprenorphine subdermal implant 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 buprenorphine during and within 14 days of MAO inhibitor therapy where possible. If it is essential, monitor closely for agitation, hyperthermia, clonus and autonomic instability and stop the opioid if serotonin syndrome is suspected.
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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