Drug interactions
Dosulepin + Selegiline
Severity: Major
Dosulepin and Selegiline: 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
Combining an MAO inhibitor with a tricyclic antidepressant such as dosulepin can cause serotonin syndrome and hypertensive reactions. The risk is highest with transdermal selegiline at antidepressant doses, which has less MAO-B selectivity.
What this interaction means in plain words
Dosulepin 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.
Dosulepin belongs to Central Nervous System; Selegiline belongs to Central Nervous System.
Why it happens
MAO inhibition combined with serotonin reuptake inhibition by dosulepin leads to excess synaptic serotonin and noradrenaline.
What to do
Avoid the combination; if switching, allow a washout of at least 14 days after stopping selegiline before starting dosulepin, and the reverse as per labeling. Monitor for agitation, hyperthermia, clonus and blood pressure changes if exposure occurs.
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 Dosulepin
- Dosulepin + Isocarboxazid Contraindicated
- Dosulepin + Phenelzine Contraindicated
- Dosulepin + Thioridazine Contraindicated
- Dosulepin + Tranylcypromine Contraindicated
- Amitriptyline + Dosulepin Major
- Buprenorphine + Dosulepin Major
Frequently asked questions
Can I take Dosulepin with Selegiline?
MediHelp rates the interaction as major. Dosulepin 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. Combining an MAO inhibitor with a tricyclic antidepressant such as dosulepin can cause serotonin syndrome and hypertensive reactions. The risk is highest with transdermal selegiline at antidepressant doses, which has less MAO-B selectivity.
How serious is the interaction between Dosulepin 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; if switching, allow a washout of at least 14 days after stopping selegiline before starting dosulepin, and the reverse as per labeling. Monitor for agitation, hyperthermia, clonus and blood pressure changes if exposure occurs.
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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