Drug interactions
Protriptyline + Rasagiline
Severity: Major
Protriptyline and Rasagiline: 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
Tricyclic antidepressants combined with MAO inhibitors have been associated with serotonin syndrome, severe CNS toxicity with hyperpyrexia, and blood pressure changes. Rasagiline labeling advises against the combination.
What this interaction means in plain words
Protriptyline and Rasagiline 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
Additive serotonergic and noradrenergic effects from MAO inhibition plus reuptake inhibition by the tricyclic.
What to do
Avoid concurrent use; allow at least 14 days after stopping rasagiline before starting protriptyline. If the combination is unavoidable, monitor closely for serotonin toxicity and blood pressure changes.
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 Rasagiline
- Atomoxetine + Rasagiline Contraindicated
- Brimonidine + Rasagiline Contraindicated
- Bupropion-naltrexone + Rasagiline Contraindicated
- Bupropion + Rasagiline Contraindicated
- Clomipramine + Rasagiline Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
Frequently asked questions
Can I take Protriptyline with Rasagiline?
MediHelp rates the interaction as major. Protriptyline and Rasagiline 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. Tricyclic antidepressants combined with MAO inhibitors have been associated with serotonin syndrome, severe CNS toxicity with hyperpyrexia, and blood pressure changes. Rasagiline labeling advises against the combination.
How serious is the interaction between Protriptyline and Rasagiline?
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 concurrent use; allow at least 14 days after stopping rasagiline before starting protriptyline. If the combination is unavoidable, monitor closely for serotonin toxicity and blood pressure changes.
What other medicines interact with Rasagiline?
MediHelp also lists interactions of Rasagiline with, for example, Atomoxetine, Brimonidine, Bupropion-naltrexone. The full list is on the Rasagiline page.
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