Drug interactions
Morphine + Selegiline
Severity: Major
Morphine and Selegiline: major interaction.
Last updated Sources: UK SmPC
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
Selegiline, especially the transdermal form which inhibits both MAO-A and MAO-B, may interact with opioids to cause serotonin syndrome or marked CNS depression and hypotension. Labeling advises avoiding opioids with the patch.
What this interaction means in plain words
Morphine 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.
Morphine belongs to Musculoskeletal; Selegiline belongs to Central Nervous System.
Why it happens
MAO inhibition may potentiate serotonergic and CNS depressant effects of morphine.
What to do
Avoid if possible; if morphine is required, use a reduced dose with slow titration and monitor sedation, blood pressure and signs of serotonin toxicity.
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 Morphine
- Alvimopan + Morphine Contraindicated
- Isocarboxazid + Morphine Contraindicated
- Morphine + Olanzapine / samidorphan Contraindicated
- Morphine + Phenelzine Contraindicated
- Morphine + Tranylcypromine Contraindicated
- Alfentanil + Morphine Major
Other interactions of Selegiline
- Amitriptyline + Selegiline Contraindicated
- Amoxapine + Selegiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
- Benzphetamine + Selegiline Contraindicated
- Brimonidine + Selegiline Contraindicated
- Buprenorphine long-acting + Selegiline Contraindicated
Frequently asked questions
Can I take Morphine with Selegiline?
MediHelp rates the interaction as major. Morphine 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. Selegiline, especially the transdermal form which inhibits both MAO-A and MAO-B, may interact with opioids to cause serotonin syndrome or marked CNS depression and hypotension. Labeling advises avoiding opioids with the patch.
How serious is the interaction between Morphine 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 if possible; if morphine is required, use a reduced dose with slow titration and monitor sedation, blood pressure and signs of serotonin toxicity.
What other medicines interact with Morphine?
MediHelp also lists interactions of Morphine with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Morphine page.
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