Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Both of these medicines can increase the level of serotonin in your body.
What might happen:
High serotonin levels may cause changes in body temperature, blood pressure and behavior, leading to a medical condition called Serotonin Syndrome. Serotonin Syndrome may be life threatening.
What you should do about this interaction:
Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together.If you experience muscle twitching, tremors, shivering or stiffness, fever, heavy sweating, heart palpitations, restlessness, confusion, agitation, trouble with coordination, or severe diarrhea contact your doctor right away.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Ketter TA, Post RM, Parekh PI, Worthington K. Addition of monoamine oxidase inhibitors to carbamazepine: preliminary evidence of safety and antidepressant efficacy in treatment-resistant depression. J Clin Psychiatry 1995 Oct;56(10):471-5.
2.Tegretol (carbamazepine) US prescribing information. Novartis Pharmaceuticals Corporation January, 2014.
3.Parnate (tranylcypromine sulfate) US prescribing information. GlaxoSmithKline May, 2010.
4.Emsam (selegline) US prescribing information. Somerset February, 2008.
5.Barklage NE, Jefferson JW, Margolis D. Do monoamine oxidase inhibitors alter carbamazepine blood levels?. J Clin Psychiatry 1992 Jul;53(7):258.
6.Lydiard RB, White D, Harvey B, Taylor A. Lack of pharmacokinetic interaction between tranylcypromine and carbamazepine. J Clin Psychopharmacol 1987 Oct;7(5):360.
7.Joffe RT, Post RM, Uhde TW. Lack of pharmacokinetic interaction of carbamazepine with tranylcypromine. Arch Gen Psychiatry 1985 Jul; 42(7):738.
8.Piscitelli SC, Burstein AH, Chaitt D, Alfaro RM, Falloon J. Indinavir concentrations and St John's wort. Lancet 2000 Feb 12;355(9203):547-8.
9.Anonymous. From the Food and Drug Administration. JAMA 2000 Apr 5; 283(13):1679.
10.Ramsay RR, Dunford C, Gillman PK. Methylene blue and serotonin toxicity: inhibition of monoamine oxidase A (MAO A) confirms a theoretical prediction. Br J Pharmacol 2007 Nov;152(6):946-51.
11.Peter C, Hongwan D, Kupfer A, Lauterburg BH. Pharmacokinetics and organ distribution of intravenous and oral methylene blue. Eur J Clin Pharmacol 2000 Jun;56(3):247-50.
12.Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005 Mar 17; 352(11):1112-20.