Drug interactions
selegiline + xylometazoline
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.
Overview
MAO inhibition can markedly potentiate the pressor effects of topical nasal sympathomimetics, risking hypertensive crisis and arrhythmias.
Mechanism of action
Pharmacodynamic: MAO inhibition increases synaptic catecholamines; xylometazoline is an alpha-adrenergic agonist. Combined effect → excessive vasoconstriction and hypertension.
Clinical management
Avoid concomitant use and for 14 days after stopping selegiline. Recommend non-sympathomimetic alternatives (e.g., saline, intranasal corticosteroid). If inadvertent exposure, monitor BP/HR and seek medical care.
Drug reference
References
- EMSAM (selegiline transdermal system) Prescribing Information — FDA Label
- Otrivine (xylometazoline) nasal spray SmPC — MHRA SmPC
- Selegiline: Drug Interactions — Lexicomp
Frequently asked questions
Can I take selegiline with xylometazoline?
The interaction is rated: Contraindicated. MAO inhibition can markedly potentiate the pressor effects of topical nasal sympathomimetics, risking hypertensive crisis and arrhythmias.
How serious is the interaction between selegiline and xylometazoline?
The interaction is rated: Contraindicated. Evidence level: High.
How is the interaction between selegiline and xylometazoline managed?
Avoid concomitant use and for 14 days after stopping selegiline. Recommend non-sympathomimetic alternatives (e.g., saline, intranasal corticosteroid). If inadvertent exposure, monitor BP/HR and seek medical care.
Why do selegiline and xylometazoline interact?
Pharmacodynamic: MAO inhibition increases synaptic catecholamines; xylometazoline is an alpha-adrenergic agonist. Combined effect → excessive vasoconstriction and hypertension.
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