Drug interactions
Diamorphine + Selegiline
Severity: Major
Diamorphine 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
Opioids given with MAO inhibitors can cause unpredictable reactions, including CNS and respiratory depression, hypotension or serotonin-like hyperthermia and agitation. Risk is greater with transdermal or higher-dose selegiline.
What this interaction means in plain words
Diamorphine 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
Additive CNS depression and possible serotonergic effects with MAO inhibition; mechanism not fully defined.
What to do
Avoid where possible. If needed, use reduced doses with careful titration and monitor respiration, temperature, blood pressure and consciousness.
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 Diamorphine with Selegiline?
MediHelp rates the interaction as major. Diamorphine 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. Opioids given with MAO inhibitors can cause unpredictable reactions, including CNS and respiratory depression, hypotension or serotonin-like hyperthermia and agitation. Risk is greater with transdermal or higher-dose selegiline.
How serious is the interaction between Diamorphine 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 where possible. If needed, use reduced doses with careful titration and monitor respiration, temperature, blood pressure and consciousness.
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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