of benzhydrocodone/acetaminophen by serotonin levels. Avoid or Use Alternate Drug. MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (eg, respiratory depression, coma). Opioids are not recommended for patients taking MAOIs or within 14 days of stopping MAOIs. If urgent opioid treatment needed, use test doses and frequent titration of small doses to treat pain while closely monitoring blood pressure and signs and symptoms of CNS and respiratory depression.buprenorphinephenelzine increases toxicity of buprenorphine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.buprenorphine buccalphenelzine increases toxicity of buprenorphine buccal by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.butorphanolphenelzine increases toxicity of butorphanol by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.cocaine topicalphenelzine and cocaine topical both increase serotonin levels. Contraindicated.codeinephenelzine increases toxicity of codeine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.desfluranephenelzine increases levels of desflurane by pharmacodynamic synergism. Avoid or Use Alternate Drug.dexfenfluraminephenelzine and dexfenfluramine both increase serotonin levels. Avoid or Use Alternate Drug.dextroamphetaminephenelzine and dextroamphetamine both increase serotonin levels. Avoid or Use Alternate Drug.dextromoramidephenelzine increases toxicity of dextromoramide by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.diamorphinephenelzine increases toxicity of diamorphine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.difenoxin hclphenelzine increases toxicity of difenoxin hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.dihydroergotaminephenelzine and dihydroergotamine both increase serotonin levels. Avoid or Use Alternate Drug.dihydroergotamine intranasalphenelzine and dihydroergotamine intranasal both increase serotonin levels. Avoid or Use Alternate Drug.diphenoxylate hclphenelzine increases toxicity of diphenoxylate hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.dipipanonephenelzine increases toxicity of dipipanone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.dolasetrondolasetron, phenelzine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.dopexaminephenelzine increases effects of dopexamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.doxapramdoxapram increases effects of phenelzine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.doxepin creamphenelzine increases levels of doxepin cream by pharmacodynamic synergism. Contraindicated. D/C MAO inhibitor 2 weeks before.eletriptaneletriptan and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug.phenelzine increases levels of eletriptan by decreasing metabolism. Contraindicated.epinephrine racemicphenelzine increases effects of epinephrine racemic by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.ergotaminephenelzine and ergotamine both increase serotonin levels. Avoid or Use Alternate Drug.fenfluraminephenelzine and fenfluramine both increase serotonin levels. Avoid or Use Alternate Drug.fluvoxaminefluvoxamine and phenelzine both increase serotonin levels. Contraindicated.formoterolphenelzine increases effects of formoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.frovatriptanfrovatriptan and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug.phenelzine increases levels of frovatriptan by decreasing metabolism. Contraindicated.granisetrongranisetron, phenelzine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.hydrocodonephenelzine increases toxicity of hydrocodone by serotonin levels. Avoid or Use Alternate Drug. MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (eg, respiratory depression, coma). Opioids are not recommended for patients taking MAOIs or within 14 days of stopping MAOIs. If urgent opioid treatment needed, use test doses and frequent titration of small doses to treat pain while closely monitoring blood pressure and signs and symptoms of CNS and respiratory depression.hydromorphonephenelzine increases toxicity of hydromorphone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.iobenguane I 131phenelzine will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.isoniazidphenelzine and isoniazid both increase serotonin levels. Avoid or Use Alternate Drug.ketaminephenelzine increases levels of ketamine by pharmacodynamic synergism. Avoid or Use Alternate Drug.L-tryptophanphenelzine and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug.levalbuterolphenelzine increases effects of levalbuterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.levorphanolphenelzine increases toxicity of levorphanol by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.linezolidlinezolid and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.lithiumphenelzine and lithium both increase serotonin levels. Avoid or Use Alternate Drug.lorcaserinphenelzine and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.lsdphenelzine and lsd both increase serotonin levels. Avoid or Use Alternate Drug.metaproterenolphenelzine increases effects of metaproterenol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.methadonephenelzine increases toxicity of methadone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.methylene bluemethylene blue and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.metoclopramide intranasalmetoclopramide intranasal increases toxicity of phenelzine by Other (see comment). Avoid or Use Alternate Drug. Comment: Metoclopramide may enhance the hypertensive effect of monoamine oxidase inhibitors.mirtazapinephenelzine and mirtazapine both increase serotonin levels. Avoid or Use Alternate Drug.morphinephenelzine and morphine both increase serotonin levels. Avoid or Use Alternate Drug.phenelzine increases toxicity of morphine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.nalbuphinephenelzine increases toxicity of nalbuphine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.naratriptannaratriptan and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug.phenelzine increases levels of naratriptan by decreasing metabolism. Contraindicated.netupitant/palonosetronnetupitant/palonosetron, phenelzine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.ondansetronondansetron, phenelzine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.opium tincturephenelzine increases toxicity of opium tincture by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.oxycodonephenelzine increases toxicity of oxycodone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.oxymetazoline intranasalphenelzine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Avoid or Use Alternate Drug. MAOIs cause norepinephrine accumulation within adrenergic neurons. Significant hypertension can result if coadministered with alpha1 agonists.oxymorphonephenelzine increases toxicity of oxymorphone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.palonosetronpalonosetron, phenelzine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.papaveretumphenelzine increases toxicity of papaveretum by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.pentazocinephenelzine and pentazocine both increase serotonin levels. Avoid or Use Alternate Drug.phenelzine increases toxicity of pentazocine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.pirbuterolphenelzine increases effects of pirbuterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.propofolphenelzine increases levels of propofol by pharmacodynamic synergism. Avoid or Use Alternate Drug.rizatriptanrizatriptan and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug.phenelzine increases levels of rizatriptan by decreasing metabolism. Contraindicated.salmeterolphenelzine increases effects of salmeterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.SAMephenelzine and SAMe both increase serotonin levels. Avoid or Use Alternate Drug.sevofluranephenelzine increases levels of sevoflurane by pharmacodynamic synergism. Avoid or Use Alternate Drug.sufentanilphenelzine increases toxicity of sufentanil by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.sufentanil SLphenelzine increases toxicity of sufentanil SL by serotonin levels. Avoid or Use Alternate Drug. MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (eg, respiratory depression, coma). Opioids are not recommended for patients taking MAOIs or within 14 days of stopping MAOIs. If urgent opioid treatment needed, use test doses and frequent titration of small doses to treat pain while closely monitoring blood pressure and signs and symptoms of CNS and respiratory depression.sumatriptansumatriptan and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug.phenelzine increases levels of sumatriptan by decreasing metabolism. Contraindicated.sumatriptan intranasalsumatriptan intranasal and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug.phenelzine increases levels of sumatriptan intranasal by decreasing metabolism. Contraindicated.tapentadolphenelzine increases toxicity of tapentadol by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.tedizolidtedizolid, phenelzine. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Interaction with MAOIs were not studied in clinical trials; drugs within the same class(eg linezolid) are contraindicated with MAOIs.terbutalinephenelzine increases effects of terbutaline by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.tramadolphenelzine and tramadol both increase serotonin levels. Avoid or Use Alternate Drug.phenelzine increases toxicity of tramadol by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.umeclidinium bromide/vilanterol inhaledphenelzine and umeclidinium bromide/vilanterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Exercise extreme caution if vilanterol coadministered with MAOIs or TCAs, or within 2 weeks of discontinuation of these drugs; adrenergic agonist effects on the cardiovascular system may be potentiatedvalbenazinephenelzine, valbenazine. Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of valbenazine with MAOIs may increase monoamine neurotransmitter concentration in synapses, potentially increasing risk of serotonin syndrome or attenuating valbenazine effect.vilanterol/fluticasone furoate inhaledphenelzine and vilanterol/fluticasone furoate inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Exercise extreme caution if vilanterol coadministered with MAOIs or TCAs, or within 2 weeks of discontinuation of these drugs; adrenergic agonist effects on the cardiovascular system may be potentiatedzolmitriptanzolmitriptan and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug.phenelzine increases levels of zolmitriptan by decreasing metabolism. Contraindicated.Monitor Closely (87)aripiprazolephenelzine, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).asenapinephenelzine, asenapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).benazeprilphenelzine, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increases risk of hypotension.bretyliumphenelzine increases effects of bretylium by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Modify Therapy/Monitor Closely. Bretylium produces release of catecholamines from nerve endings. This increased catecholamine release is potentiated by MAOIs.brompheniraminephenelzine increases effects of brompheniramine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Coadministration of phenelzine and antihistamines may result in additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .bupivacaine implantphenelzine, bupivacaine implant. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia.buprenorphine subdermal implantphenelzine, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.buprenorphine, long-acting injectionphenelzine, buprenorphine, long-acting injection. Either