Drug interactions
Selegiline + Tyramine
Severity: Major
Selegiline and Tyramine: 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
Tyramine is a dietary amine normally broken down by MAO in the gut and liver. With nonselective MAO inhibition, such as higher-dose selegiline or the transdermal patch at higher strengths, large intakes can cause hypertensive crisis. At low oral doses the risk is small.
What this interaction means in plain words
Selegiline and Tyramine 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 blocks tyramine breakdown, so more tyramine reaches the circulation and releases norepinephrine from nerve endings.
What to do
Counsel patients to avoid tyramine-rich foods such as aged cheeses, cured meats, fermented products and tap beer when on higher-dose or transdermal selegiline. Seek urgent care for severe headache or palpitations.
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 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 Selegiline with Tyramine?
MediHelp rates the interaction as major. Selegiline and Tyramine 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. Tyramine is a dietary amine normally broken down by MAO in the gut and liver. With nonselective MAO inhibition, such as higher-dose selegiline or the transdermal patch at higher strengths, large intakes can cause hypertensive crisis. At low oral doses the risk is small.
How serious is the interaction between Selegiline and Tyramine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Counsel patients to avoid tyramine-rich foods such as aged cheeses, cured meats, fermented products and tap beer when on higher-dose or transdermal selegiline. Seek urgent care for severe headache or palpitations.
What other medicines interact with Selegiline?
MediHelp also lists interactions of Selegiline with, for example, Amitriptyline, Amoxapine, Atomoxetine. The full list is on the Selegiline page.
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