Drug interactions
Remifentanil + Selegiline
Severity: Moderate
Remifentanil and Selegiline: moderate 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-B inhibitor that loses selectivity at higher doses, and opioids with serotonergic activity given with MAO inhibitors have been linked to serotonin syndrome. Remifentanil is not a strong serotonergic opioid, but the perioperative setting makes any reaction clinically important. Labeling for remifentanil advises caution with MAO inhibitors.
What this interaction means in plain words
Remifentanil and Selegiline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Remifentanil belongs to Musculoskeletal; Selegiline belongs to Central Nervous System.
Why it happens
Possible additive serotonergic and sympathomimetic effects when MAO inhibition is combined with an opioid.
What to do
Tell the anesthesia team about selegiline use before surgery and monitor for autonomic instability, hyperthermia and neuromuscular excitation. Prefer opioids with little serotonergic activity and avoid meperidine, tramadol and methadone.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
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 Remifentanil with Selegiline?
MediHelp rates the interaction as moderate. Remifentanil and Selegiline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Selegiline is an MAO-B inhibitor that loses selectivity at higher doses, and opioids with serotonergic activity given with MAO inhibitors have been linked to serotonin syndrome. Remifentanil is not a strong serotonergic opioid, but the perioperative setting makes any reaction clinically important. Labeling for remifentanil advises caution with MAO inhibitors.
How serious is the interaction between Remifentanil and Selegiline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Tell the anesthesia team about selegiline use before surgery and monitor for autonomic instability, hyperthermia and neuromuscular excitation. Prefer opioids with little serotonergic activity and avoid meperidine, tramadol and methadone.
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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