Drug interactions
Midodrine + Selegiline
Severity: Major
Midodrine and Selegiline: 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
Midodrine is an alpha-1 agonist that raises blood pressure, and MAO inhibition may potentiate pressor effects. Transdermal selegiline at antidepressant doses inhibits MAO nonselectively, risking severe hypertension.
What this interaction means in plain words
Midodrine and Selegiline 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.
Midodrine belongs to Miscellaneous; Selegiline belongs to Central Nervous System.
Why it happens
Additive pressor effects with MAO inhibition potentiating sympathomimetic activity.
What to do
Avoid with antidepressant-dose transdermal selegiline. If used with oral low-dose selegiline, monitor blood pressure closely including supine readings.
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 Midodrine and Selegiline, 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 7 days on the web. No card needed.
References
Other interactions of Selegiline
- Amitriptyline + Selegiline Contraindicated
- Amoxapine + Selegiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
- Benzphetamine + Selegiline Contraindicated
- Brimonidine + Selegiline Contraindicated
- Buprenorphine long-acting + Selegiline Contraindicated
Other interactions of Midodrine
- Isocarboxazid + Midodrine Contraindicated
- Midodrine + Phenelzine Contraindicated
- Midodrine + Tranylcypromine Contraindicated
- Dextroamphetamine + Midodrine Major
- Dihydroergotamine intranasal + Midodrine Major
- Dihydroergotamine + Midodrine Major
Frequently asked questions
Can I take Midodrine with Selegiline?
MediHelp rates the interaction as major. Midodrine and Selegiline 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. Midodrine is an alpha-1 agonist that raises blood pressure, and MAO inhibition may potentiate pressor effects. Transdermal selegiline at antidepressant doses inhibits MAO nonselectively, risking severe hypertension.
How serious is the interaction between Midodrine and Selegiline?
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 with antidepressant-dose transdermal selegiline. If used with oral low-dose selegiline, monitor blood pressure closely including supine readings.
What other medicines interact with Selegiline?
MediHelp also lists interactions of Selegiline with, for example, Amitriptyline, Amoxapine, Atomoxetine. The full list is on the Selegiline 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.
