Drug interactions
Diamorphine + Tranylcypromine
Severity: Major
Diamorphine 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
Diamorphine (heroin) with an MAO inhibitor can cause exaggerated opioid effects including respiratory depression, coma, hypotension or hypertension, and hyperthermia. Serotonin syndrome is also a concern.
What this interaction means in plain words
Diamorphine 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 CNS effects and serotonergic activity; the precise mechanism is not established.
What to do
Avoid the combination and wait 14 days after stopping tranylcypromine before using diamorphine. If an opioid is essential, use reduced, carefully titrated doses and monitor respiration, sedation, blood pressure and temperature.
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 Diamorphine with Tranylcypromine?
MediHelp rates the interaction as major. Diamorphine 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. Diamorphine (heroin) with an MAO inhibitor can cause exaggerated opioid effects including respiratory depression, coma, hypotension or hypertension, and hyperthermia. Serotonin syndrome is also a concern.
How serious is the interaction between Diamorphine 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 the combination and wait 14 days after stopping tranylcypromine before using diamorphine. If an opioid is essential, use reduced, carefully titrated doses and monitor respiration, sedation, blood pressure and temperature.
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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