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Oritavancin: Coadministration of oritavancin and selegiline may result in increases or decreases in selegiline exposure and may increase side effects or decrease efficacy of selegiline.
Selegiline is metabolized by CYP3A4 and CYP2C9. Oritavancin weakly induces CYP3A4, while weakly inhibiting CYP2C9. If these drugs are administered concurrently, monitor the patient for signs of toxicity or lack of efficacy.
Oxazepam: The CNS-depressant effects of MAOIs can be potentiated with concomitant administration of other drugs known to cause CNS depression including benzodiazepines. Oxcarbazepine: The manufacturer of selegiline, transdermal specifically contraindicates combined use with oxcarbazepine. Oxcarbazepine and carbamazepine share structural and chemical properties, and carbamazepine is contraindicated for use with MAOIs due to its structural similarity to tricyclic antidepressants.
Hypertensive crises, seizures, coma, or circulatory collapse may theoretically occur in patients receiving carbamazepine and selegiline. Concurrent administration of carbamazepine and transdermal selegiline has resulted in elevated selegiline concentrations, but the clinical relevance of these observations is unknown.
Clinical data on the potential interaction between oxcarbazepine and selegiline is lacking. Nevertheless, the manufacturer of selegiline, transdermal recommends that it be discontinued for a minimum of 14 days or longer before administering oxcarbazepine.
At least one week should elapse between discontinuation of oxcarbazepine and initiation of therapy with selegiline, transdermal.
Minoxidil: Additive hypotensive effects may be seen when monoamine oxidase inhibitors MAOIs are combined with antihypertensives or medications with hypotensive properties. Mirabegron: While the manufacturer does not discuss the use of mirabegron in patients on MAOI therapy, it may be best to use this combination cautiously.
Mirabegron is a selective beta-3 adrenergic agonist that may elevate blood pressure slightly at clinically used doses, and it is possible that this sympathomimetic activity could raise the risk of hypertensive crisis in patients receiving monoamine oxidase inhibitors MAOIssimilar to other adrenergic medications. Beta-3 selectivity is usually lost at doses above those used clinically for overactive bladder i.
Sympathomimetic adrenergic agonists are typically contraindicated in patients receiving MAOIs. Mirtazapine: Due to the risk of serotonin syndrome, monoamine oxidase inhibitors MAOIs intended to treat psychiatric disorders are contraindicated for use with heterocyclic antidepressants e. Mitotane: Use caution if mitotane and selegiline are used concomitantly, and monitor for decreased efficacy of selegiline and a possible change in dosage requirements.
Modafinil: Modafinil has not been evaluated for drug interactions with monoamine oxidase inhibitors MAOIs. Until more is known regarding the pharmacology of modafinil, it is prudent avoid the use of modafinil in the presence of an MAO inhibitor.
Due to the prolonged duration of action of MAOIs, a period of at least 14 days between the last dose of the MAOI and the first dose of modafinil should elapse. Moexipril: Additive hypotensive effects may be seen when monoamine oxidase inhibitors MAOIs are combined with antihypertensives.
Morphine: Morphine use is contraindicated in patients who are receiving or who have received monoamine oxidase inhibitors MAOIs within the previous 14 days.
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Patients must be closely monitored until the symptoms have stabilized. Transdermal selegiline is contraindicated in patients with pheochromocytoma. The associated tumor secretes pressor substances e. Oral forms of selegiline should generally also be avoided in these patients, due to similar reasons. The use of antidepressants, such as transdermal selegiline, has been associated with the precipitation of mania or hypomania in susceptible individuals.
If a patient develops manic symptoms, transdermal selegiline should be withheld, and appropriate therapy initiated to treat the manic symptoms. Patients should be adequately screened for bipolar disorder prior to initiating an antidepressant.
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Whether the increased risk observed was due to Parkinson's disease or other factors, such as drugs used to treat Parkinson's disease, is unclear. For the reasons stated above, patients and providers are advised to monitor for melanomas frequently and on a regular basis when using ELDEPRYL for any indication. Ideally, periodic skin examinations should be performed by appropriately qualified individuals e. Patients should be advised of the possible need to reduce levodopa dosage after the initiation of ELDEPRYL therapy.
Patients or their families if the patient is incompetent should be advised not to exceed the daily recommended dose of 10 mg.
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Aprepitant is also a CYP2C9 inducer and selegiline is a CYP2C9 substrate in vitro. The effects of aprepitant on tolbutamide were not considered significant. Armodafinil: Armodafinil has not been evaluated for drug interactions with monoamine oxidase inhibitors MAOIs.
It is known that many other CNS stimulants may induce severe cardiovascular and cerebrovascular responses if administered in combination with drugs with non-selective MAO inhibitor activity. Until more is known regarding the pharmacology of armodafinil, it is prudent avoid the use of armodafinil in the presence of an MAO inhibitor.
Due to the prolonged duration of action of MAOIs, a period of at least 14 days between the last dose of the MAOI and the first dose of armodafinil should elapse.
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In number of medical conditions like Alzheimer's disease, Attention deficit hyperactivity disorder ADHDDepression, Narcolepsy and Schizophrenia, this medication is highly effective.
However, control in food intake rich in tyramine, such as pickled, smoked or fermented meat and cheese, is still advised.
Desmopressin: Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including MAOIs.
MAOIs should not be used within 5 days of discontinuing treatment with duloxetine or within 7 days of discontinuing treatment with other SNRIs.
The CNS-depressant effects of MAOIs can be potentiated with concomitant administration of other drugs known to cause CNS depression including benzodiazepines. Amlodipine: Additive hypotensive effects may be seen when monoamine oxidase inhibitors MAOIs are combined with antihypertensives. Careful monitoring of blood pressure is suggested during concurrent therapy of MAOIs with angiotensin-converting enzyme inhibitors ACE inhibitors.
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Eldepryl is a drug with low bioavailabilty and should be taken with a meal, most preferably rich in fat.
Additive CNS depression may occur if butalbital is used concomitantly with monoamine oxidase inhibitors.