Drug interactions
Methylenedioxymethamphetamine + Tranylcypromine
Severity: Contraindicated
Methylenedioxymethamphetamine and Tranylcypromine: 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
MDMA releases serotonin and norepinephrine in large amounts, and MAO inhibition prevents their breakdown. This can cause hypertensive crisis, severe hyperthermia and serotonin syndrome, with fatalities reported with MAOI and MDMA use.
What this interaction means in plain words
Methylenedioxymethamphetamine and Tranylcypromine 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
Massive monoamine release by MDMA combined with irreversible MAO inhibition causes serotonergic and sympathomimetic toxicity.
What to do
Avoid. Counsel patients on tranylcypromine about the danger of recreational MDMA, and treat suspected toxicity as an emergency with cooling, benzodiazepines and blood pressure control.
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 Tranylcypromine
- 5-HTP + Tranylcypromine Contraindicated
- Amitriptyline + Tranylcypromine Contraindicated
- Amoxapine + Tranylcypromine Contraindicated
- Atomoxetine + Tranylcypromine Contraindicated
- Benzphetamine + Tranylcypromine Contraindicated
- Brimonidine + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Methylenedioxymethamphetamine with Tranylcypromine?
MediHelp rates the interaction as contraindicated. Methylenedioxymethamphetamine and Tranylcypromine 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. MDMA releases serotonin and norepinephrine in large amounts, and MAO inhibition prevents their breakdown. This can cause hypertensive crisis, severe hyperthermia and serotonin syndrome, with fatalities reported with MAOI and MDMA use.
How serious is the interaction between Methylenedioxymethamphetamine and Tranylcypromine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid. Counsel patients on tranylcypromine about the danger of recreational MDMA, and treat suspected toxicity as an emergency with cooling, benzodiazepines and blood pressure control.
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.
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