Drug interactions
Opium tincture + Tranylcypromine
Severity: Major
Opium tincture 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
Combining a nonselective MAOI with opioids such as those in opium tincture can cause unpredictable reactions, including serotonin-like toxicity with agitation, hyperthermia and autonomic instability, or profound CNS and respiratory depression with hypotension. Fatal outcomes have been reported with MAOI-opioid combinations.
What this interaction means in plain words
Opium tincture 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.
Why it happens
MAO inhibition may enhance serotonergic activity and opioid effects; the exact mechanism varies by opioid and is not fully established.
What to do
Avoid opioids during MAOI therapy and for 14 days after stopping tranylcypromine. If an opioid is essential, choose a non-serotonergic agent, start with small test doses and monitor blood pressure, temperature, mental status and respiration.
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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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 Opium tincture with Tranylcypromine?
MediHelp rates the interaction as major. Opium tincture 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. Combining a nonselective MAOI with opioids such as those in opium tincture can cause unpredictable reactions, including serotonin-like toxicity with agitation, hyperthermia and autonomic instability, or profound CNS and respiratory depression with hypotension. Fatal outcomes have been reported with MAOI-opioid combinations.
How serious is the interaction between Opium tincture 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 opioids during MAOI therapy and for 14 days after stopping tranylcypromine. If an opioid is essential, choose a non-serotonergic agent, start with small test doses and monitor blood pressure, temperature, mental status and respiration.
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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