Drug interactions
Isocarboxazid + Tapentadol
Severity: Contraindicated
Isocarboxazid and Tapentadol: contraindicated interaction.
Last updated
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
Tapentadol inhibits norepinephrine reuptake, and with an MAO inhibitor this can cause hypertensive crisis, serotonin-like toxicity, agitation and hyperthermia. Tapentadol is contraindicated during and for 14 days after MAOI therapy.
What this interaction means in plain words
Isocarboxazid and Tapentadol 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.
Isocarboxazid belongs to Central Nervous System; Tapentadol belongs to Musculoskeletal.
Why it happens
MAO inhibition combined with tapentadol's noradrenergic reuptake inhibition leads to excess monoamine activity in the synapse.
What to do
Do not coadminister, and do not start tapentadol within 14 days of stopping the MAOI. Use a non-serotonergic, non-noradrenergic analgesic alternative.
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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Other interactions of Tapentadol
- Calcium / magnesium / potassium / sodium oxybates + Tapentadol Contraindicated
- Linezolid + Tapentadol Contraindicated
- Methylene blue + Tapentadol Contraindicated
- Olanzapine / samidorphan + Tapentadol Contraindicated
- Phenelzine + Tapentadol Contraindicated
- Procarbazine + Tapentadol Contraindicated
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 Tapentadol?
MediHelp rates the interaction as contraindicated. Isocarboxazid and Tapentadol 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. Tapentadol inhibits norepinephrine reuptake, and with an MAO inhibitor this can cause hypertensive crisis, serotonin-like toxicity, agitation and hyperthermia. Tapentadol is contraindicated during and for 14 days after MAOI therapy.
How serious is the interaction between Isocarboxazid and Tapentadol?
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 coadminister, and do not start tapentadol within 14 days of stopping the MAOI. Use a non-serotonergic, non-noradrenergic analgesic alternative.
What other medicines interact with Tapentadol?
MediHelp also lists interactions of Tapentadol with, for example, Calcium / magnesium / potassium / sodium oxybates, Linezolid, Methylene blue. The full list is on the Tapentadol page.
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