Drug interactions
Dextromoramide + Tranylcypromine
Severity: Major
Dextromoramide 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
Dextromoramide is a potent opioid, and combining it with an MAO inhibitor risks severe CNS and respiratory depression, blood pressure instability and possibly serotonin syndrome. Serious reactions are described for MAOIs with opioids.
What this interaction means in plain words
Dextromoramide 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
MAO inhibition may potentiate opioid effects and serotonergic activity; the exact mechanism is not fully established.
What to do
Avoid during tranylcypromine therapy and for 14 days after stopping it; use a non-opioid or alternative analgesic. If unavoidable, use small titrated doses with close monitoring of respiration, sedation 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 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 Dextromoramide with Tranylcypromine?
MediHelp rates the interaction as major. Dextromoramide 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. Dextromoramide is a potent opioid, and combining it with an MAO inhibitor risks severe CNS and respiratory depression, blood pressure instability and possibly serotonin syndrome. Serious reactions are described for MAOIs with opioids.
How serious is the interaction between Dextromoramide 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 during tranylcypromine therapy and for 14 days after stopping it; use a non-opioid or alternative analgesic. If unavoidable, use small titrated doses with close monitoring of respiration, sedation and blood pressure.
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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