Drug interactions
Mavacamten + Tranylcypromine
Severity: Major
Mavacamten and Tranylcypromine: major 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
Mavacamten is cleared largely by CYP2C19, and tranylcypromine has been reported to inhibit this enzyme. Higher mavacamten exposure can cause excessive reduction of ejection fraction and heart failure from systolic dysfunction. The legacy classification is contraindicated, but the clinical evidence for tranylcypromine is mostly mechanistic.
What this interaction means in plain words
Mavacamten 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.
Mavacamten belongs to Cardiovascular; Tranylcypromine belongs to Central Nervous System.
Why it happens
Tranylcypromine inhibits CYP2C19, reducing mavacamten metabolism and raising its plasma concentration.
What to do
Avoid if possible. If it cannot be avoided, monitor LVEF and Valsalva gradient closely and adjust the mavacamten dose per labeling.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Mavacamten and Tranylcypromine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Tranylcypromine
- 5-HTP + Tranylcypromine Contraindicated
- Amitriptyline + Tranylcypromine Contraindicated
- Amoxapine + Tranylcypromine Contraindicated
- Atomoxetine + Tranylcypromine Contraindicated
- Benzphetamine + Tranylcypromine Contraindicated
- Brimonidine + Tranylcypromine Contraindicated
Other interactions of Mavacamten
- Apalutamide + Mavacamten Contraindicated
- Carbamazepine + Mavacamten Contraindicated
- Clarithromycin + Mavacamten Contraindicated
- Dexlansoprazole + Mavacamten Contraindicated
- Efavirenz + Mavacamten Contraindicated
- Enzalutamide + Mavacamten Contraindicated
Frequently asked questions
Can I take Mavacamten with Tranylcypromine?
MediHelp rates the interaction as major. Mavacamten 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. Mavacamten is cleared largely by CYP2C19, and tranylcypromine has been reported to inhibit this enzyme. Higher mavacamten exposure can cause excessive reduction of ejection fraction and heart failure from systolic dysfunction. The legacy classification is contraindicated, but the clinical evidence for tranylcypromine is mostly mechanistic.
How serious is the interaction between Mavacamten 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 if possible. If it cannot be avoided, monitor LVEF and Valsalva gradient closely and adjust the mavacamten dose per labeling.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
