ultram and Atapryl Interactions

Interactions between ultram(traMADOL) and Atapryl (selegiline)

selegiline and traMADOL (Major Drug-Drug)

GENERALLY AVOID: Monoamine oxidase inhibitors (MAOIs) may potentiate the serotonergic activity of tramadol and increase the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors. The mechanism is an additive pharmacodynamic effect resulting from MAOI inhibition of serotonin metabolism. Patients receiving this combination of drugs may also experience an increased risk of seizures due to lowering of seizure threshold.

MANAGEMENT: In general, tramadol should not be used concurrently with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, procarbazine) unless potential benefit is deemed to outweigh the risk. If the combination is used, close monitoring is recommended for signs and symptoms of excessive serotonergic activity such as CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia. Ideally, 7 to 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with tramadol.