Drug interactions
Cocaine + Phenelzine
Severity: Contraindicated
Cocaine and Phenelzine: 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
Cocaine blocks reuptake of norepinephrine, dopamine and serotonin, while phenelzine prevents breakdown of these amines. Together they can cause marked sympathetic stimulation with severe hypertension, hyperthermia, arrhythmias and serotonin toxicity. Topical cocaine has limited absorption but the combination is still labeled as contraindicated.
What this interaction means in plain words
Cocaine and Phenelzine 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.
Cocaine belongs to Central Nervous System; Phenelzine belongs to Central Nervous System.
Why it happens
Irreversible MAO inhibition plus monoamine reuptake blockade leads to excess synaptic catecholamines and serotonin.
What to do
Avoid cocaine, including topical anesthetic use, in patients taking phenelzine or within 14 days of stopping it; choose a different local anesthetic. If exposure occurs, monitor blood pressure, heart rate and temperature and treat hypertensive crisis or serotonin toxicity urgently.
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?
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Other interactions of Phenelzine
- 5-HTP + Phenelzine Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amoxapine + Phenelzine Contraindicated
- Atomoxetine + Phenelzine Contraindicated
- Benzphetamine + Phenelzine Contraindicated
- Brimonidine + Phenelzine Contraindicated
Other interactions of Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Citalopram + Cocaine Major
- Clomipramine + Cocaine Major
Frequently asked questions
Can I take Cocaine with Phenelzine?
MediHelp rates the interaction as contraindicated. Cocaine and Phenelzine 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. Cocaine blocks reuptake of norepinephrine, dopamine and serotonin, while phenelzine prevents breakdown of these amines. Together they can cause marked sympathetic stimulation with severe hypertension, hyperthermia, arrhythmias and serotonin toxicity. Topical cocaine has limited absorption but the combination is still labeled as contraindicated.
How serious is the interaction between Cocaine and Phenelzine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid cocaine, including topical anesthetic use, in patients taking phenelzine or within 14 days of stopping it; choose a different local anesthetic. If exposure occurs, monitor blood pressure, heart rate and temperature and treat hypertensive crisis or serotonin toxicity urgently.
What other medicines interact with Phenelzine?
MediHelp also lists interactions of Phenelzine with, for example, 5-HTP, Amitriptyline, Amoxapine. The full list is on the Phenelzine page.
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