Sympathomimetics (Indirect & Mixed Acting)/MAOIs Interactions
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
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:
When these two medicines are taken together, your body may not process sympathomimetics properly.
What might happen:
You may experience increased blood pressure, rapid heartbeat, seizures, or hallucinations.
What you should do about this interaction:
Contact your healthcare professionals (e.g. doctor or pharmacist) as soon as possible about taking these two medicines together. They 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.Goldberg LI. Monoamine oxidase inhibitors. Adverse reactions and possible mechanisms. JAMA 1964 Nov 2;190(5):456-62.
- 2.Pettinger WA, Soyangco FG, Oates JA. Inhibition of monoamine oxidase in man by furazolidone. Clin Pharmacol Ther 1968 Jul-Aug;9(4):442-7.
- 3.Nardil (phenelzine sulfate) US prescribing information. Parke-Davis May, 2007.
- 4.Adderall XR (amphetamine) US prescribing information. Shire US Inc. April, 2015.
- 5.Marplan (isocarboxazid) US prescribing information. Validus Pharmaceuticals August, 2007.
- 6.Ritalin LA (methylphenidate hydrochloride) US prescribing information. Novartis Pharmaceuticals Corporation November, 2019.
- 7.Focalin (dexmethylphenidate hydrochloride) US prescribing information. Novartis Pharmaceuticals Corporation January, 2019.
- 8.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.
- 9.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.
- 10.Parnate (tranylcypromine sulfate) US prescribing information. GlaxoSmithKline January 4, 2018.
- 11.Cuthbert MF, Greenberg MP, Morley SW. Cough and cold remedies: a potential danger to patients on monoamine oxidase inhibitors. Br Med J 1969 Feb 15;1(5641):404-6.
- 12.Smookler S, Bermudez AJ. Hypertensive crisis resulting from an MAO inhibitor and an over-the-counter appetite suppressant. Ann Emerg Med 1982 Sep;11(9):482-4U.
- 13.Mason AM, Buckle RM. "Cold" cures and monoamine-oxidase inhibitors. Br Med J 1969 Mar 29;1(5647):845-6.
- 14.LLOYD JT, WALKER DR. DEATH AFTER COMBINED DEXAMPHETAMINE AND PHENELZINE. Br Med J 1965 Jul 17;2(5454):168-9.
- 15.Krisko I, Lewis E, Johnson JE 3rd. Severe hyperpyrexia due to tranylcypromine-amphetamine toxicity. Ann Intern Med 1969 Mar; 70(3):559-64.
- 16.Boakes AJ, Laurence DR, Teoh PC, Barar FS, Benedikter LT, Prichard BN. Interactions between sympathomimetic amines and antidepressant agents in man. Br Med J 1973 Feb 10;1(5849):311-5.
- 17.Elis J, Laurence DR, Mattie H, Prichard BN. Modification by monoamine oxidase inhibitors of the effect of some sympathomimetics on blood pressure. Br Med J 1967 Apr 8;2(5544):75-8.
- 18.HORWITZ D, GOLDBERG LI, SJOERDSMA A. Increased blood pressure responses to dopamine and norepinephrine produced by monoamine oxidase inhibitors in man. J Lab Clin Med 1960 Nov;56:747-53.
- 19.Cuthbert MF, Vere DW. Potentiation of the cardiovascular effects of some catecholamines by a monoamine oxidase inhibitor. Br J Pharmacol 1971 Oct; 43(2):471P-472P.
- 20.Hornykiewicz O. Dopamine (3-hydroxytyramine) and brain function. Pharmacol Rev 1966 Jun;18(2):925-64.
- 21.GOLDBERG LI. MONOAMINE OXIDASE INHIBITORS. ADVERSE REACTIONS AND POSSIBLE MECHANISMS. JAMA 1964 Nov 2;190:456-62.
- 22.Kopin IJ. Biochemical aspects of release of norepinephrine and other amines from sympathetic nerve endings. Pharmacol Rev 1966 Mar; 18(1):513-23.
- 23.BETHUNE HC, BURRELL RH, CULPAN RH, OGG GJ. VASCULAR CRISES ASSOCIATED WITH MONOAMINE-OXIDASE INHIBITORS. Am J Psychiatry 1964 Sep;121:245-8.
- 24.O'Dea K, Rand MJ. Interaction between amphetamine and monoamine oxidase inhibitors. Eur J Pharmacol 1969 May;6(2):115-20.
- 25.Eldepryl (selegiline) US prescribing information. Somerset Pharmaceuticals February, 1997.
- 26.Emsam (selegline) US prescribing information. Somerset July, 2017.
- 27.Azilect (rasagiline) US prescribing information. Teva Neurosciences Inc. June, 2020.
- 28.Phansalkar S, Desai AA, Bell D, Yoshida E, Doole J, Czochanski M, Middleton B, Bates DW. High-priority drug-drug interactions for use in electronic health records. J Am Med Inform Assoc 2012 Sep-Oct; 19(5):735-43.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.