Drug interactions
Isocarboxazid + Pentazocine
Severity: Major
Isocarboxazid and Pentazocine: 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 an opioid analgesic can cause unpredictable reactions, including profound hypotension, hyperthermia, marked sedation, respiratory depression and occasionally death. Serotonin toxicity is also a concern with this combination.
What this interaction means in plain words
Isocarboxazid and Pentazocine 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.
Isocarboxazid belongs to Central Nervous System; Pentazocine belongs to Musculoskeletal.
Why it happens
Irreversible MAO inhibition may potentiate opioid CNS and cardiovascular depression and may contribute to serotonergic toxicity; the exact mechanism is not fully established.
What to do
Avoid pentazocine during and for 14 days after stopping isocarboxazid; choose a non-opioid or alternative analgesic. If unavoidable, use a reduced starting dose and monitor blood pressure, temperature, mental status and respiration.
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 Pentazocine
- Calcium / magnesium / potassium / sodium oxybates + Pentazocine Contraindicated
- Olanzapine / samidorphan + Pentazocine Contraindicated
- Pentazocine + Phenelzine Contraindicated
- Pentazocine + Tranylcypromine Contraindicated
- Alfentanil + Pentazocine Major
- Alprazolam + Pentazocine Major
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 Pentazocine?
MediHelp rates the interaction as major. Isocarboxazid and Pentazocine 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 an opioid analgesic can cause unpredictable reactions, including profound hypotension, hyperthermia, marked sedation, respiratory depression and occasionally death. Serotonin toxicity is also a concern with this combination.
How serious is the interaction between Isocarboxazid and Pentazocine?
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 pentazocine during and for 14 days after stopping isocarboxazid; choose a non-opioid or alternative analgesic. If unavoidable, use a reduced starting dose and monitor blood pressure, temperature, mental status and respiration.
What other medicines interact with Pentazocine?
MediHelp also lists interactions of Pentazocine with, for example, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan, Phenelzine. The full list is on the Pentazocine page.
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