Posted by laima on February 23, 2007, at 14:42:09
In reply to Master list of drugs to avoid while on MAOIs?, posted by UgottaHaveHope on February 23, 2007, at 13:05:20
My doctor gave me a couple xeroxed pages right out of one of his own books. (Unfortunately, I don't know the name of the book or publication date- but I reckon it's up to date, as he tends to always be very up to date.) Here's a quick summary:
ANTIASTHMATICS: Oxtriphylline, Alluterol- "Combined with phenelzine, may lead to apprehension, tachycardia, and palpitations."
Isoetharine- "Combined with phenelzine, may lead to hypomania (one case report)."
ANTIBIOTICS: Sulfisoxazole- "Combined with phenelzine, may lead to ataxia, vertigo, tinnitus, muscle pain, and paresthesias."
ANTICHOLINERGICS: Atropine, Scopolamine (potentiated with maois)
ANTIDEPRESSENTS: "Danger of this combo. may be exaggerated, but several reports indicate combined therapy may lead to potentially fatal interaction. Commonly described symptoms: diaphoresis, tremor, fever, confusion, agitation, dyspnea, hallucinations, hypotension, convulsions, coma, and death. Combination may be safe when certain guidelines are followed: start both drugs simultaneously in lower than usual doses, only viua the oral route."
"Amitriptyline, trimipramine, nortriptyline: Appear safest."
"Imipramine, desipramine, clomipramine: Should not be used."
Serotonergic Antidepressents: "Fluoxitine should be avoided, but there is a case report of uncomplicated use of trazadone and phenelzine."
ANTIHYPERTENSIVES: Reserpine ("autonomic excitation, delirious agitation, hypertension"), clonidine ("possibly hypertensive reaction, but clinical experience is lacking"), propranolol ("low doses have been safely used", higher doses= possible hypertensive reactions), thiazides: ("Hypotensive action potentiated."), Guanethidine: ("Antihypertensive effects blocked.")
ATRACURIUM: (a (ie, one) case report of hypertension over just minutes)
BARBITUATES: "Tranylcypromine may prolong barbituate-induced hypnosis"
BENZODIAZEPINES: "One group reports a disinhibited state"..."This combo widely used without serious interactions."
BUSPIRONE: "Manufacturer reports four known cases of elevated blood pressure with this combination. However, many patients taking this combination do not experience blood pressure alterations".
ETHANOL: "Alchoholic beverages with high typramine content..."
GINSENG: "May cause headache, temulousness, or hypomanic symptoms in patients taking phenelzine."
HYPOGLYCEMIC AGENTS (ie, insulin, sulfonylurea hypoglycemics): "Enhanced hypoglycemic responses have been reported."
LITHIUM: says, "The combination may be useful in treatment of refractory depression."
NARCOTIC ANALGESICS: meperidine, dextromethorphan--basically says "hypotension and hypertension"; m. can also cause "excitement, diaphoresis, rigidity, hyper-reflexia, hyperthermia, tachycardia, coma, and death". d. "may also cause a hypertensive, hypermetabolic reaction with maois".
Morphine, Codeine, Fentanyl: "Less likely to interact when used in reduced dosages."
NEUROLEPTICS: "The combination may lead to enhanced anticholinergic side effects and extrapyramidal symptoms. Clinical use includes protection against MAOI-tyramine hypertensive crisis and treatment of anhedonic schizophrenics."
PROTEIN DIETARY SUPPLEMENT: "One case report describes a patient on ..phenelzine who experienced a hypertensive crisis...product...contained yeast, yeast spirulina, or yeast extract."
SUCCINYLCHOLINE: "Phenelzine may reduce cholinesterase levels and lead to prolonged apnea during ECT or surgical procedures. Other MAOIs do not appear to have this effect."
SYMPATHOMIMETICS: Indirect, direct- "...amines may interact with maois", "indirect" are "more dangerous". "Concomitant use may lead to hypertension, agitation, fever, convulsion, coma. However, recent case reports suggest that dextroamphetamine, methylphenidate, and phentermine may have a role when coprescribed with an MAOI in treatment-resistant depressions."
TRYPTOPHAN: "Occcasionally used as a hypnotic in patients taking MAOIs or to potentiate the MAOI antidepressent effect. It may cause delirium, myoclonus, or hypomania."
VERAPAMIL: "...blocks phenelzine-induced hypomania."
In addition, in conversation, he told me novocane, ie at the dentist, can be a problem. Weird, huh?Phenelzyn- is that parnate? That one sure seems to have to most potential for interactions!
poster:laima
thread:735398
URL: http://www.dr-bob.org/babble/20070219/msgs/735425.html