Drug interactions
Ondansetron + Tranylcypromine
Severity: Major
Ondansetron 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
Serotonin syndrome has been reported when 5-HT3 antagonists are given with serotonergic drugs, including MAO inhibitors. Tranylcypromine increases synaptic serotonin and could add to this risk, causing agitation, hyperthermia, clonus and autonomic instability.
What this interaction means in plain words
Ondansetron 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.
Ondansetron belongs to Gastrointestinal Tract; Tranylcypromine belongs to Central Nervous System.
Why it happens
Additive serotonergic effect from irreversible MAO inhibition together with 5-HT3 receptor antagonism; the contribution of ondansetron is not well defined.
What to do
Prefer a non-serotonergic antiemetic where possible. If given, use the lowest dose and monitor for signs of serotonin toxicity, stopping both drugs if it develops.
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 Ondansetron 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 Ondansetron
- Apomorphine + Ondansetron Contraindicated
- Ondansetron + Thioridazine Contraindicated
- Ondansetron + Vandetanib Contraindicated
- Adagrasib + Ondansetron Major
- Amiodarone + Ondansetron Major
- Amisulpride + Ondansetron Major
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 Ondansetron with Tranylcypromine?
MediHelp rates the interaction as major. Ondansetron 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. Serotonin syndrome has been reported when 5-HT3 antagonists are given with serotonergic drugs, including MAO inhibitors. Tranylcypromine increases synaptic serotonin and could add to this risk, causing agitation, hyperthermia, clonus and autonomic instability.
How serious is the interaction between Ondansetron 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: Prefer a non-serotonergic antiemetic where possible. If given, use the lowest dose and monitor for signs of serotonin toxicity, stopping both drugs if it develops.
What other medicines interact with Ondansetron?
MediHelp also lists interactions of Ondansetron with, for example, Apomorphine, Thioridazine, Vandetanib. The full list is on the Ondansetron 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.
