Drug interactions
Dextromoramide + Selegiline
Severity: Major
Dextromoramide 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
Strong opioids given with MAO inhibitors may cause serotonin-like excitation with hyperthermia or severe CNS and respiratory depression with hypotension. Selegiline, particularly transdermal, raises this concern.
What this interaction means in plain words
Dextromoramide 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.
Why it happens
Possible serotonergic potentiation and additive CNS depression with MAO inhibition; not fully established.
What to do
Avoid the combination and use an alternative analgesic. If unavoidable, give low doses with close monitoring of respiration, temperature and blood pressure.
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
Frequently asked questions
Can I take Dextromoramide with Selegiline?
MediHelp rates the interaction as major. Dextromoramide 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. Strong opioids given with MAO inhibitors may cause serotonin-like excitation with hyperthermia or severe CNS and respiratory depression with hypotension. Selegiline, particularly transdermal, raises this concern.
How serious is the interaction between Dextromoramide 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 and use an alternative analgesic. If unavoidable, give low doses with close monitoring of respiration, temperature and blood pressure.
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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