NPHMonitor Closely (1)phenelzine increases effects of insulin NPH by unknown mechanism. Use Caution/Monitor.insulin regular humanMonitor Closely (1)phenelzine increases effects of insulin regular human by unknown mechanism. Use Caution/Monitor.iobenguane I 131Serious - Use Alternative (1)phenelzine 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.isocarboxazidContraindicated (1)isocarboxazid and phenelzine both increase serotonin levels. Contraindicated.isomethepteneContraindicated (1)phenelzine, isometheptene. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Hypertension, V tach.isoniazidSerious - Use Alternative (1)phenelzine and isoniazid both increase serotonin levels. Avoid or Use Alternate Drug.isoproterenolContraindicated (1)phenelzine increases effects of isoproterenol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.ketamineSerious - Use Alternative (1)phenelzine increases levels of ketamine by pharmacodynamic synergism. Avoid or Use Alternate Drug.L-tryptophanSerious - Use Alternative (1)phenelzine and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug.lasmiditanMonitor Closely (2)lasmiditan, phenelzine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions. phenelzine increases effects of lasmiditan by serotonin levels. Use Caution/Monitor. Coadministration may increase risk of serotonin syndrome.lemborexantMonitor Closely (1)lemborexant, phenelzine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.levalbuterolSerious - Use Alternative (1)phenelzine increases effects of levalbuterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.levocetirizineMonitor Closely (1)phenelzine increases effects of levocetirizine 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. .levodopaContraindicated (1)phenelzine, levodopa. Mechanism: pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.levodopa inhaledContraindicated (1)levodopa inhaled increases effects of phenelzine by dopaminergic effects. Contraindicated. Levodopa may enhance risk for acute hypertensive episode if coadministered with nonselective MAOIs. Discontinue use of any nonselective MAO inhibitors at least 2 weeks before initiating levodopa inhaled.levomilnacipranContraindicated (1)phenelzine and levomilnacipran both increase serotonin levels. Contraindicated. Do not use MAOIs intended to treat psychiatric disorders with levomilnacipran or within 7 days of stopping levomilnacipran due to an increased risk of serotonin syndromelevorphanolSerious - Use Alternative (1)phenelzine increases toxicity of levorphanol by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.linezolidSerious - Use Alternative (1)linezolid 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.lisdexamfetamineContraindicated (1)phenelzine, lisdexamfetamine. Either increases effects of the other by serotonin levels. Contraindicated. Do not use amphetamines during and within 14 days of discontinuation of monoamine oxidase inhibitors. .lithiumMonitor Closely (1)lithium, phenelzine. Mechanism: unknown. Use Caution/Monitor. Risk of malignant hyperpyrexia. Interactions esp. expected w/non selective MAOIs.Serious - Use Alternative (1)phenelzine and lithium both increase serotonin levels. Avoid or Use Alternate Drug.lofepramineContraindicated (1)phenelzine and lofepramine both increase serotonin levels. Contraindicated.loratadineMonitor Closely (1)phenelzine increases effects of loratadine 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. .lorcaserinSerious - Use Alternative (1)phenelzine and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.loxapineMonitor Closely (1)phenelzine, loxapine. 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).loxapine inhaledMonitor Closely (1)phenelzine, loxapine inhaled. 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).lsdSerious - Use Alternative (1)phenelzine and lsd both increase serotonin levels. Avoid or Use Alternate Drug.lurasidoneMonitor Closely (3)lurasidone increases effects of phenelzine by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed. lurasidone, phenelzine. Either increases toxicity of the other by sedation. Use Caution/Monitor. Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity. phenelzine, lurasidone. 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).maprotilineContraindicated (1)phenelzine and maprotiline both increase serotonin levels. Contraindicated.meperidineContraindicated (2)phenelzine and meperidine both increase serotonin levels. Contraindicated. phenelzine increases toxicity of meperidine by unknown mechanism. Contraindicated.metaproterenolSerious - Use Alternative (1)phenelzine increases effects of metaproterenol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.metforminMonitor Closely (1)phenelzine will increase the level or effect of metformin by unspecified interaction mechanism. Use Caution/Monitor.methadoneSerious - Use Alternative (1)phenelzine increases toxicity of methadone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.methamphetamineContraindicated (1)phenelzine increases effects of methamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.methylene blueSerious - Use Alternative (1)methylene 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.methylenedioxymethamphetamineContraindicated (1)phenelzine increases effects of methylenedioxymethamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.methylphenidateContraindicated (1)phenelzine increases effects of methylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI.methylphenidate transdermalContraindicated (1)methylphenidate transdermal and phenelzine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Contraindicated. Coadministration of MAOIs and CNS stimulants can cause hypertensive crisis.metoclopramide intranasalSerious - Use Alternative (1)metoclopramide 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.metrizamideMonitor Closely (1)phenelzine, metrizamide. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Risk of seizure. D/C MAO inhibitor 24h before admin. of metrizamide.midodrineContraindicated (1)phenelzine increases effects of midodrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.milnacipranContraindicated (1)phenelzine and milnacipran both increase serotonin levels. Contraindicated.mirtazapineSerious - Use Alternative (1)phenelzine and mirtazapine both increase serotonin levels. Avoid or Use Alternate Drug.modafinilContraindicated (1)phenelzine increases effects of modafinil by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.molindoneMonitor Closely (1)phenelzine, molindone. 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).morphineSerious - Use Alternative (2)phenelzine 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.nalbuphineSerious - Use Alternative (1)phenelzine increases toxicity of nalbuphine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.naratriptanSerious - Use Alternative (2)naratriptan and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug. phenelzine increases levels of naratriptan by decreasing metabolism. Contraindicated.nefazodoneContraindicated (1)phenelzine and nefazodone both increase serotonin levels. Contraindicated.netupitant/palonosetronSerious - Use Alternative (1)netupitant/palonosetron, phenelzine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.norepinephrineContraindicated (1)phenelzine increases effects of norepinephrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.nortriptylineContraindicated (1)phenelzine and nortriptyline both increase serotonin levels. Contraindicated.olanzapineMonitor Closely (1)phenelzine, olanzapine. 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).oliceridineMonitor Closely (1)phenelzine, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. If concomitant use is warranted, carefully monitor, particularly during treatment initiation and dose adjustment. Discontinue oliceridine if serotonin syndrome is suspected. .olodaterol inhaledMonitor Closely (1)phenelzine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. MAO inhibitors prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasondansetronSerious - Use Alternative (1)ondansetron, phenelzine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.opicaponeContraindicated (1)opicapone, phenelzine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Both nonselective MAO inhibitors and opicapone inhibit catecholamine metabolism, leading to increased levels of catecholamines. Potential for dangerously high HR or BP.opium tinctureMonitor Closely (1)opium tincture, phenelzine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of serotonin syndrome.Serious - Use Alternative (1)phenelzine increases toxicity of opium tincture by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.oxycodoneSerious - Use Alternative (1)phenelzine increases toxicity of oxycodone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.oxymetazoline intranasalSerious - Use Alternative (1)phenelzine 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.oxymetazoline topicalMonitor Closely (1)oxymetazoline topical and phenelzine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.oxymorphoneSerious - Use Alternative (1)phenelzine increases toxicity of oxymorphone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.ozanimodContraindicated (1)phenelzine and ozanimod both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Contraindicated. Coadministration of ozanimod with MAO-B inhibitors may decrease exposure of the active metabolites of ozanimod, which may inhibit MAO. The potential for a clinical interaction with MAO inhibitors has not been studied; however, the increased risk of nonselective MAO inhibition may lead to a hypertensive crisis. Allow at least 14 days to elapse between discontinuing ozanimod and initiating with MAO inhibitors.paliperidoneMonitor Closely (1)phenelzine, paliperidone. 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).palonosetronSerious - Use Alternative (1)palonosetron, phenelzine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.panax ginsengMinor (1)panax ginseng increases effects of phenelzine by pharmacodynamic synergism. Minor/Significance Unknown.papaveretumSerious - Use Alternative (1)phenelzine increases toxicity of papaveretum by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.paroxetineContraindicated (1)phenelzine and paroxetine both increase serotonin levels. Contraindicated.pentazocineSerious - Use Alternative (2)phenelzine 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.pentobarbitalMinor (1)phenelzine increases levels of pentobarbital by decreasing metabolism. Minor/Significance Unknown. Theoretical interaction.perphenazineMonitor Closely (1)phenelzine, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome.