Drug interactions
Remifentanil + Selegiline transdermal
Severity: Major
Remifentanil and Selegiline transdermal: 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
Selegiline is an MAO inhibitor, and combining MAOIs with opioids can precipitate serotonin syndrome or other severe reactions. The risk is higher with serotonergic opioids, and remifentanil is less serotonergic, but caution is still warranted.
What this interaction means in plain words
Remifentanil and Selegiline transdermal 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 combined with opioid effects may increase serotonergic and sympathetic activity.
What to do
Avoid use where possible, or use only with close monitoring for agitation, hyperthermia, rigidity and blood pressure changes. Choose non-serotonergic analgesic alternatives and stop both agents if serotonin syndrome 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?
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Other interactions of Remifentanil
- Alvimopan + Remifentanil Contraindicated
- Isocarboxazid + Remifentanil Contraindicated
- Olanzapine / samidorphan + Remifentanil Contraindicated
- Phenelzine + Remifentanil Contraindicated
- Benzhydrocodone / acetaminophen + Remifentanil Major
- Brexanolone + Remifentanil Major
Frequently asked questions
Can I take Remifentanil with Selegiline transdermal?
MediHelp rates the interaction as major. Remifentanil and Selegiline transdermal 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 is an MAO inhibitor, and combining MAOIs with opioids can precipitate serotonin syndrome or other severe reactions. The risk is higher with serotonergic opioids, and remifentanil is less serotonergic, but caution is still warranted.
How serious is the interaction between Remifentanil and Selegiline transdermal?
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 use where possible, or use only with close monitoring for agitation, hyperthermia, rigidity and blood pressure changes. Choose non-serotonergic analgesic alternatives and stop both agents if serotonin syndrome develops.
What other medicines interact with Remifentanil?
MediHelp also lists interactions of Remifentanil with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Remifentanil page.
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