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:
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 or mood, 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 professional (e.g. doctor or pharmacist) knows that you are taking these medicines together.If you experience muscle twitching, tremors, shivering and 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.Rivers N, Horner B. Possible lethal reaction between Nardil and dextromethorphan. Can Med Assoc J 1970 Jul;103:85.
2.Sovner R, Wolfe J. Interaction between dextromethorphan and monoamine oxidase inhibitor therapy with isocarboxazid. N Engl J Med 1988 Dec 22; 319(25):1671.
3.Noble WH, Baker A. MAO inhibitors and coronary artery surgery: a patient death. Can J Anaesth 1992 Dec;39(10):1061-6.
4.DBL fentanyl injection Australian prescribing information. FH Faulding & Co Limited t/a David Bull Laboratories October 31, 2003.
5.Actiq (fentanyl citrate) Australian prescribing information. Orphan Australia Pty Ltd. November 2, 2002.
6.Actiq (fentanyl citrate) US prescribing information. Cephalon, Inc. December, 2016.
7.Duragesic (fentanyl) US prescribing information. Janssen Pharmaceuticals, Inc. August, 2014.
8.Sublimaze (fentanyl citrate) US prescribing information. Taylor Pharmaceuticals 2005.
9.Huang V, Gortney JS. Risk of serotonin syndrome with concomitant administration of linezolid and serotonin agonists. Pharmacotherapy 2006 Dec;26(12):1784-93.
10.Gillman PK. Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity. Br J Anaesth 2005 Oct;95(4):434-41.
11.FDA (US Food and Drug Administration). FDA Drug Safety Communication: FDA warns about several safety issues with opioid pain medicines; requires label changes. available at: http://www.fda.gov/Drugs/DrugSafety/ucm489676.htm March 22, 2016.
12.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.