diminish the serotonergic effect of MAO inhibitors.desfluraneSerious - Use Alternative (1)phenelzine increases levels of desflurane by pharmacodynamic synergism. Avoid or Use Alternate Drug.desipramineContraindicated (1)phenelzine and desipramine both increase serotonin levels. Contraindicated.desloratadineMonitor Closely (1)phenelzine increases effects of desloratadine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Potential for dangerous interaction. Use with caution and monitor closely.desvenlafaxineContraindicated (1)phenelzine and desvenlafaxine both increase serotonin levels. Contraindicated. At least 14 days should elapse between discontinuation of MAOIs and initiation of treatment with a serotonergic drugdeutetrabenazineContraindicated (1)phenelzine, deutetrabenazine. Either increases levels of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Contraindicated. Deutetrabenazine should not be used in combination with an MAOI, or within 14 days of discontinuing therapy with an MAOI.dexchlorpheniramineMonitor Closely (1)phenelzine increases effects of dexchlorpheniramine 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. .dexfenfluramineContraindicated (1)phenelzine increases effects of dexfenfluramine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.Serious - Use Alternative (1)phenelzine and dexfenfluramine both increase serotonin levels. Avoid or Use Alternate Drug.dexmethylphenidateContraindicated (1)phenelzine increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.dextroamphetamineContraindicated (1)phenelzine increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.Serious - Use Alternative (1)phenelzine and dextroamphetamine both increase serotonin levels. Avoid or Use Alternate Drug.dextroamphetamine transdermalContraindicated (1)phenelzine increases effects of dextroamphetamine transdermal by decreasing metabolism. Contraindicated. MAOIs slows amphetamine metabolism, increasing amphetamine?s effect on norepinephrine release and other monoamines from adrenergic nerve endings causing signs of hypertensive crisis. Do not administer dextroamphetamine during or within 14 days following MAOI administration.Monitor Closely (1)phenelzine, dextroamphetamine transdermal. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue dextroamphetamine transdermal and concomitant serotonergic drug(s).dextromethorphanContraindicated (1)phenelzine and dextromethorphan both increase serotonin levels. Contraindicated.dextromoramideSerious - Use Alternative (1)phenelzine increases toxicity of dextromoramide by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.diamorphineSerious - Use Alternative (1)phenelzine increases toxicity of diamorphine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.diazepam intranasalMonitor Closely (1)diazepam intranasal, phenelzine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.dichlorphenamideMonitor Closely (1)dichlorphenamide, phenelzine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.diethylpropionContraindicated (1)phenelzine increases effects of diethylpropion by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.difenoxin hclMonitor Closely (1)difenoxin hcl, phenelzine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of serotonin syndrome.Serious - Use Alternative (1)phenelzine increases toxicity of difenoxin hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.dihydroergotamineSerious - Use Alternative (1)phenelzine and dihydroergotamine both increase serotonin levels. Avoid or Use Alternate Drug.dihydroergotamine intranasalSerious - Use Alternative (1)phenelzine and dihydroergotamine intranasal both increase serotonin levels. Avoid or Use Alternate Drug.diphenhydramineMonitor Closely (1)phenelzine increases effects of diphenhydramine 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. .diphenoxylate hclMonitor Closely (1)diphenoxylate hcl, phenelzine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of serotonin syndrome.Serious - Use Alternative (1)phenelzine increases toxicity of diphenoxylate hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.dipipanoneSerious - Use Alternative (1)phenelzine increases toxicity of dipipanone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.disulfiramMinor (1)disulfiram, phenelzine. Mechanism: unknown. Minor/Significance Unknown. Risk of delirium (case report).dobutamineContraindicated (1)phenelzine increases effects of dobutamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.dolasetronSerious - Use Alternative (1)dolasetron, phenelzine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.donepezil transdermalMonitor Closely (1)donepezil transdermal, phenelzine. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.dopamineContraindicated (1)phenelzine increases effects of dopamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.dopexamineSerious - Use Alternative (1)phenelzine increases effects of dopexamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.dosulepinContraindicated (1)phenelzine and dosulepin both increase serotonin levels. Contraindicated.doxapramSerious - Use Alternative (1)doxapram increases effects of phenelzine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.doxepinContraindicated (1)phenelzine and doxepin both increase serotonin levels. Contraindicated.doxepin creamSerious - Use Alternative (1)phenelzine increases levels of doxepin cream by pharmacodynamic synergism. Contraindicated. D/C MAO inhibitor 2 weeks before.doxylamineMonitor Closely (1)phenelzine increases effects of doxylamine 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. .duloxetineContraindicated (1)phenelzine and duloxetine both increase serotonin levels. Contraindicated.eletriptanSerious - Use Alternative (2)eletriptan and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug. phenelzine increases levels of eletriptan by decreasing metabolism. Contraindicated.entacaponeContraindicated (1)entacapone, phenelzine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Both nonselective MAO inhibitors and entacapone inhibit catecholamine metabolism, leading to increased levels of catecholamines. Potential for dangerously high HR or BP.ephedrineContraindicated (1)phenelzine increases effects of ephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.epinephrineContraindicated (1)phenelzine increases effects of epinephrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.epinephrine inhaledContraindicated (1)phenelzine and epinephrine inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Contraindicated. Coadministration of epinephrine inhaled with MAOIs or within 2 weeks after discontinuing an MAOI is contraindicated.epinephrine racemicSerious - Use Alternative (1)phenelzine increases effects of epinephrine racemic by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.ergotamineSerious - Use Alternative (1)phenelzine and ergotamine both increase serotonin levels. Avoid or Use Alternate Drug.escitalopramContraindicated (1)phenelzine and escitalopram both increase serotonin levels. Contraindicated.esketamine intranasalMonitor Closely (1)esketamine intranasal, phenelzine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with MAO-Is. .etomidateMonitor Closely (1)phenelzine increases levels of etomidate by pharmacodynamic synergism. Use Caution/Monitor.fenfluramineContraindicated (2)phenelzine increases effects of fenfluramine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. fenfluramine, phenelzine. Either increases effects of the other by serotonin levels. Contraindicated. Coadministration with drugs that increase serotonin may increase the risk of serotonin syndrome. Do not use concomitantly or within 14 days of MAOIs.Serious - Use Alternative (1)phenelzine and fenfluramine both increase serotonin levels. Avoid or Use Alternate Drug.fentanylContraindicated (1)phenelzine increases toxicity of fentanyl by Other (see comment). Contraindicated. Comment: Avoid fentanyl in patients who require concomitant administration MAOIs, or within 14 days of stopping an MAOI. Severe and unpredictable potentiation by MAO inhibitors has been reported with opioid analgesics.fentanyl intranasalContraindicated (1)phenelzine increases toxicity of fentanyl intranasal by Other (see comment). Contraindicated. Comment: Avoid fentanyl in patients who require concomitant administration MAOIs, or within 14 days of stopping an MAOI. Severe and unpredictable potentiation by MAO inhibitors has been reported with opioid analgesics.fentanyl transdermalContraindicated (1)phenelzine increases toxicity of fentanyl transdermal by Other (see comment). Contraindicated. Comment: Avoid fentanyl in patients who require concomitant administration MAOIs, or within 14 days of stopping an MAOI. Severe and unpredictable potentiation by MAO inhibitors has been reported with opioid analgesics.fentanyl transmucosalContraindicated (1)phenelzine increases toxicity of fentanyl transmucosal by Other (see comment). Contraindicated. Comment: Avoid fentanyl in patients who require concomitant administration MAOIs, or within 14 days of stopping an MAOI. Severe and unpredictable potentiation by MAO inhibitors has been reported with opioid analgesics.fexofenadineMonitor Closely (1)phenelzine increases effects of fexofenadine 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. .fluoxetineContraindicated (1)phenelzine and fluoxetine both increase serotonin levels. Contraindicated.fluphenazineMonitor Closely (1)phenelzine, fluphenazine. 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).fluvoxamineSerious - Use Alternative (1)fluvoxamine and phenelzine both increase serotonin levels. Contraindicated.formoterolSerious - Use Alternative (1)phenelzine increases effects of formoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.frovatriptanSerious - Use Alternative (2)frovatriptan and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug. phenelzine increases levels of frovatriptan by decreasing metabolism. Contraindicated.gabapentinMonitor Closely (1)gabapentin, phenelzine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.gabapentin enacarbilMonitor Closely (1)gabapentin enacarbil, phenelzine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.ganaxoloneMonitor Closely (1)phenelzine and ganaxolone both increase sedation. Use Caution/Monitor.glimepirideMonitor Closely (1)phenelzine increases effects of glimepiride by unknown mechanism. Use Caution/Monitor.glipizideMonitor Closely (1)phenelzine increases effects of glipizide by unknown mechanism. Use Caution/Monitor.glyburideMonitor Closely (1)phenelzine increases effects of glyburide by unknown mechanism. Use Caution/Monitor.granisetronSerious - Use Alternative (1)granisetron, phenelzine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.green teaMonitor Closely (1)green tea, phenelzine. Other (see comment). Use Caution/Monitor. Comment: Avoid combination or excessive consumption of green tea. Combination may increase risk of cardiac arrhythmias or severe hypertension can occur due to caffeine component of green tea.haloperidolMonitor Closely (1)phenelzine, haloperidol. 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).hydralazineMonitor Closely (1)hydralazine, phenelzine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of hypertension.hydrocodoneSerious - Use Alternative (1)phenelzine 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.hydromorphoneSerious - Use Alternative (1)phenelzine increases toxicity of hydromorphone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.hydroxyzineMonitor Closely (1)phenelzine increases effects of hydroxyzine 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. .iloperidoneMonitor Closely (1)phenelzine, iloperidone. 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).imipramineContraindicated (1)phenelzine and imipramine both increase serotonin levels. Contraindicated.indacaterol, inhaledMonitor Closely (1)indacaterol, inhaled, phenelzine. QTc interval. Use Caution/Monitor. Indacaterol should be administered with extreme caution to patients treated with MAO inhibitors. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.insulin aspartMonitor Closely (1)phenelzine increases effects of insulin aspart by unknown mechanism. Use Caution/Monitor.insulin degludecMonitor Closely (1)phenelzine, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.insulin degludec/insulin aspartMonitor Closely (1)phenelzine, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.insulin detemirMonitor Closely (1)phenelzine increases effects of insulin detemir by unknown mechanism. Use Caution/Monitor.insulin glargineMonitor Closely (1)phenelzine increases effects of insulin glargine by unknown mechanism. Use Caution/Monitor.insulin glulisineMonitor Closely (1)phenelzine increases effects of insulin glulisine by unknown mechanism. Use Caution/Monitor.insulin inhaledMonitor Closely (1)phenelzine, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.insulin lisproMonitor Closely (1)phenelzine increases effects of insulin lispro by unknown mechanism. Use Caution/Monitor.insulin