Drug interactions between Inderide and tranylcypromine
| Results for the following 2 drugs: |
|---|
| Inderide (hydrochlorothiazide/propranolol) |
| tranylcypromine |
Interactions between your selected drugs
propranolol ↔ tranylcypromine
Applies to:Inderide (hydrochlorothiazide/propranolol) and tranylcypromine
MONITOR: Sympathetic ganglion-blocking or catecholamine-depleting agents such as guanethidine, reserpine, and monoamine oxidase (MAO) inhibitors may potentiate the pharmacologic effects of beta-blockers, which are thought to competitively antagonize catecholamines at cardiac and other peripheral adrenergic neurons. Combining these medications may increase the risk of hypotension, orthostasis, bradycardia, and heart failure due to excessive reduction of sympathetic activity. A case report describes two elderly patients who developed bradycardia less than 2 weeks after the initiation of phenelzine during treatment with a beta-blocker (nadolol 40 mg/day or metoprolol 150 mg/day). The pulse rates returned to normal following a 50% reduction of the nadolol dosage and discontinuation of metoprolol. In another report, a young woman developed marked orthostatic hypotension following the addition of pindolol 2.5 mg three times a day to an existing regimen of tranylcypromine. The pindolol dosage was reduced to 2.5 mg twice a day until her blood pressure stabilized, then slowly increased to 5 mg three times a day.
MANAGEMENT: Caution is advised if beta-blockers, including ophthalmic formulations, are prescribed in combination with sympathetic ganglion-blocking or catecholamine-depleting agents. Patients should contact their doctor if they experience dizziness, lightheadedness, syncope, bradycardia, shortness of breath, difficulty breathing, edema, and/or chest pain.
hydrochlorothiazide ↔ tranylcypromine
Applies to:Inderide (hydrochlorothiazide/propranolol) and tranylcypromine
MONITOR: Monoamine oxidase inhibitors (MAOIs) may potentiate the hypotensive effect of some medications. MAOIs alone quite commonly produce orthostatic hypotension. This effect may stem from a gradual MAOI-induced accumulation of false neurotransmitters in peripheral adrenergic neurons that have minimal activity at alpha- and beta-adrenergic receptors, resulting in a functional block of sympathetic neurotransmission. The interaction has been reported with the concomitant use of beta-blockers. In one report, a young woman developed marked orthostatic hypotension following the addition of pindolol 2.5 mg three times a day to an existing regimen of tranylcypromine. The pindolol dosage was reduced to 2.5 mg twice a day until her blood pressure stabilized, then slowly increased to 5 mg three times a day.
MANAGEMENT: Caution is advised during coadministration of MAOIs and other medications with hypotensive effects, especially during the first few weeks of treatment. Close monitoring for development of hypotension is recommended. Ambulatory patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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