Posted by ed_uk2010 on April 21, 2014, at 14:07:59
In reply to Re: Parnate and angina, posted by kirbyw on April 20, 2014, at 17:51:09
>As for the interaction between MAOIs and Nitro, there are warnings everywhere about not using these drugs together. because of dangerously low blood pressure.
There is no evidence of a specific interaction between MAOIs and nitroglycerin. Some people develop hypotension (low blood pressure) on MAOIs. This may be increased by nitroglycerin because it also reduces blood pressure. This isn't an interaction as such, it's an additive effect ie. both meds can reduce BP. Assuming your BP is normal on Parnate, I see no reason not to use nitroglycerin if medically necessary. If your BP is abnormally low already, don't use nitroglycerin.
The same warning of an 'interaction' is automatically applied to all drugs which can potentially reduce blood pressure. It's really important to consider what someone's BP is before giving nitroglycerin rather than assuming it's contraindicated. Nitroglycerin can reduce BP with or without MAOIs, so it would not be given if BP was too low to begin with.
Interestingly, and on another subject, back in the early 1960s some doctors prescribed MAOIs such as iproniazid, isocarboxazid (Marplan) and phenelzine (Nardil) to reduce the frequency of angina attacks. The mechanism of action wasn't clear, but they seemed to improve exercise tolerance and decrease pain in some patients.
poster:ed_uk2010
thread:1064530
URL: http://www.dr-bob.org/babble/20140419/msgs/1064575.html