Drug interactions
Cocaine + Selegiline
Severity: Major
Cocaine and Selegiline: major interaction.
Last updated Sources: UK SmPC
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 monoamine reuptake and MAO inhibition prevents breakdown of monoamines. Together they may cause hypertensive crisis, arrhythmia or serotonin toxicity.
What this interaction means in plain words
Cocaine and Selegiline 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.
Cocaine belongs to Central Nervous System; Selegiline belongs to Central Nervous System.
Why it happens
Cocaine reuptake inhibition combined with MAO inhibition causes additive monoamine excess.
What to do
Avoid the combination. Where topical cocaine is essential, use the smallest dose and monitor blood pressure and heart rhythm.
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 Selegiline
- Amitriptyline + Selegiline Contraindicated
- Amoxapine + Selegiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
- Benzphetamine + Selegiline Contraindicated
- Brimonidine + Selegiline Contraindicated
- Buprenorphine long-acting + Selegiline Contraindicated
Other interactions of Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Phenelzine Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Citalopram + Cocaine Major
Frequently asked questions
Can I take Cocaine with Selegiline?
MediHelp rates the interaction as major. Cocaine and Selegiline 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. Cocaine blocks monoamine reuptake and MAO inhibition prevents breakdown of monoamines. Together they may cause hypertensive crisis, arrhythmia or serotonin toxicity.
How serious is the interaction between Cocaine and Selegiline?
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. Where topical cocaine is essential, use the smallest dose and monitor blood pressure and heart rhythm.
What other medicines interact with Selegiline?
MediHelp also lists interactions of Selegiline with, for example, Amitriptyline, Amoxapine, Atomoxetine. The full list is on the Selegiline page.
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