Drug interactions
Clozapine + Tranylcypromine
Severity: Major
Clozapine and Tranylcypromine: 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
Clozapine has serotonergic and anticholinergic activity and strong hypotensive effects. With an MAO inhibitor there is a risk of serotonin toxicity, marked hypotension, sedation and NMS-like reactions.
What this interaction means in plain words
Clozapine 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.
Clozapine belongs to Central Nervous System; Tranylcypromine belongs to Central Nervous System.
Why it happens
MAO inhibition combined with clozapine's serotonergic, alpha-adrenergic blocking and anticholinergic effects.
What to do
Avoid if possible, or use with specialist supervision, slow titration and monitoring of blood pressure, mental status and temperature. Stop both agents 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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Other interactions of Tranylcypromine
- 5-HTP + Tranylcypromine Contraindicated
- Amitriptyline + Tranylcypromine Contraindicated
- Amoxapine + Tranylcypromine Contraindicated
- Atomoxetine + Tranylcypromine Contraindicated
- Benzphetamine + Tranylcypromine Contraindicated
- Brimonidine + Tranylcypromine Contraindicated
Other interactions of Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
Frequently asked questions
Can I take Clozapine with Tranylcypromine?
MediHelp rates the interaction as major. Clozapine 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. Clozapine has serotonergic and anticholinergic activity and strong hypotensive effects. With an MAO inhibitor there is a risk of serotonin toxicity, marked hypotension, sedation and NMS-like reactions.
How serious is the interaction between Clozapine 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 if possible, or use with specialist supervision, slow titration and monitoring of blood pressure, mental status and temperature. Stop both agents 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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