ms-contin and Parnate Interactions

Interactions between ms-contin(morphine) and Parnate (tranylcypromine)

morphine and tranylcypromine (Major Drug-Drug)

CONTRAINDICATED: The coadministration of narcotic analgesics and monoamine oxidase inhibitors (MAOIs) may rarely result in hypotension, respiratory depression, or coma. The mechanism is unknown but may be related to additive CNS and respiratory depressant effects. Rare case reports of severe hypotensive reactions have included propoxyphene (with multiple medications), morphine, and methadone, although others have reported the safe use of MAOIs with narcotic analgesics including methadone and morphine.

MANAGEMENT: Some manufacturers consider the administration of narcotics and MAOIs within 2 weeks of each other to be contraindicated. However, morphine has been safely used in MAOI patients who previously had an adverse reaction with meperidine and is generally suggested as an alternative to meperidine in anesthesia, as long as vital signs are closely monitored. Other recommendations include giving patients small initial test doses of narcotics and monitoring vital signs for adverse reactions.