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Interaction with drugs

Last reviewed Jan 1, 2018

MAOIs must not be used to treat a patient if the patient is also taking drugs that depend on enzymes affected by MAOI for their metabolism, for example:-

sympathomimetic amines eg adrenaline, noradrenaline
cold cures containing phenylpropanolamine and ephedrine
methyl dopa
antihistamines
some local anaesthetics
morphine, pethidine, procaine, alcohol, insulin, barbiturates. The effects of oral hypoglycaemic drugs may be heightened.

There may be dangerous interactions between tricyclics and MAOIs, which means that a tricyclic should not be given for about 2 weeks after stopping a MAOI. A drug- free interval is not required if the tricyclic is given first, which is a reason why tricyclics are used first in depressive illness and having a MAOI as a reserve.

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