Drug interactions
Isocarboxazid + Lofepramine
Severity: Contraindicated
Isocarboxazid and Lofepramine: contraindicated 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 a nonselective MAO inhibitor with a tricyclic antidepressant such as lofepramine can precipitate serotonin syndrome and hypertensive reactions. Features include agitation, hyperthermia, clonus, autonomic instability and seizures, and the outcome can be fatal.
What this interaction means in plain words
Isocarboxazid and Lofepramine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Irreversible MAO inhibition combined with noradrenaline and serotonin reuptake inhibition leads to excess synaptic monoamines.
What to do
Do not co-administer; allow at least 14 days after stopping isocarboxazid before starting lofepramine, and an appropriate washout of lofepramine before starting the MAOI.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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References
Other interactions of Isocarboxazid
- 5-HTP + Isocarboxazid Contraindicated
- Amitriptyline + Isocarboxazid Contraindicated
- Amobarbital + Isocarboxazid Contraindicated
- Amoxapine + Isocarboxazid Contraindicated
- Apraclonidine + Isocarboxazid Contraindicated
- Atomoxetine + Isocarboxazid Contraindicated
Frequently asked questions
Can I take Isocarboxazid with Lofepramine?
MediHelp rates the interaction as contraindicated. Isocarboxazid and Lofepramine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Combining a nonselective MAO inhibitor with a tricyclic antidepressant such as lofepramine can precipitate serotonin syndrome and hypertensive reactions. Features include agitation, hyperthermia, clonus, autonomic instability and seizures, and the outcome can be fatal.
How serious is the interaction between Isocarboxazid and Lofepramine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer; allow at least 14 days after stopping isocarboxazid before starting lofepramine, and an appropriate washout of lofepramine before starting the MAOI.
What other medicines interact with Isocarboxazid?
MediHelp also lists interactions of Isocarboxazid with, for example, 5-HTP, Amitriptyline, Amobarbital. The full list is on the Isocarboxazid page.
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