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Can you take Atapryl with Venlafaxine?

1 drug interaction and 33 additional warnings found for the following 2 drugs:

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Drug interactions

Major drug interactions

Major:

selegiline venlafaxine

Applies to: Atapryl (selegiline) and venlafaxine

Using selegiline together with venlafaxine is not recommended. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. In general, you should wait at least 14 days after stopping selegiline before you start treatment with venlafaxine. Conversely, if you have recently been on venlafaxine and are now starting treatment with selegiline, you should check with your doctor or pharmacist to see how long you should wait before it is safe for you to use selegiline, as some medications can take a while to clear from your body. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food/lifestyle interactions

Major food/lifestyle interactions

Major:

selegiline Food/Lifestyle

Applies to: Atapryl (selegiline)

While you are taking selegiline, you must not eat or drink certain foods and beverages that are high in tyramine. Eating these foods while you are taking selegiline can raise your blood pressure to dangerous levels. This may cause life threatening symptoms such as sudden and severe headache, confusion, blurred vision, problems with speech or balance, nausea, vomiting, chest pain, seizure (convulsions), and sudden numbness or weakness (especially on one side of the body). Call your doctor at once if you have any of these symptoms. Foods that are high in tyramine include: air dried meats, aged or fermented meats, sausage or salami, pickled herring, and any spoiled or improperly stored beef, poultry, fish, or liver, red wine, beer from a tap, beer that has not been pasteurize, aged cheeses, including blue, brick, brie, cheddar, parmesan, romano, and swiss, sauerkraut, over the counter supplements or cough and cold medicines that contain tyramine, soy beans, soy sauce, tofu, miso soup, bean curd, fava beans, or yeast extracts (such as Marmite).

Moderate food/lifestyle interactions

Moderate:

venlafaxine Food/Lifestyle

Applies to: venlafaxine

Alcohol can increase the nervous system side effects of venlafaxine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with venlafaxine. Do not use more than the recommended dose of venlafaxine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Moderate:

selegiline Alcohol (Ethanol)

Applies to: Atapryl (selegiline)

Using selegiline together with ethanol (alcohol) may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with selegiline. Do not use more than the recommended dose of selegiline, and avoid driving, operating machinery, or engaging in potentially hazardous activities requiring mental alertness and motor coordination until you know how the medication affects you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Disease interactions

30 potential interactions Applies to: 22 conditions, including High Blood Pressure, Depression, Bipolar Disorder, Urinary Tract Infection, and Seizures.

Anorexia/Feeding Problems

Minor:

venlafaxine

Venlafaxine has a minor potential interaction with Anorexia/Feeding Problems.

The use of venlafaxine may occasionally cause significant, dose-dependent weight loss, which may be undesirable in patients suffering from anorexia, malnutrition or excessive weight loss. The loss of at least 5% of body weight occurred in 6% to 7% of treated patients in premarketing studies, compared to 1% to 2% for placebo. Anorexia may occur in approximately 10% of patients. Weight change should be monitored during therapy if venlafaxine is used in malnourished or underweight patients.

Bipolar Disorder

Major:

venlafaxine

Venlafaxine has a major potential interaction with Bipolar Disorder.

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Moderate:

venlafaxine

Venlafaxine has a moderate potential interaction with Bipolar Disorder.

Therapy with SNRI antidepressants can cause activation of mania and hypomania and should be used with caution in patients with personal or family history of mania, hypomania, bipolar disorder, and other mood disorders.

Moderate:

venlafaxine

Venlafaxine has a moderate potential interaction with Bipolar Disorder.

All antidepressants may occasionally cause mania or hypomania, particularly in patients with bipolar disorder. Therapy with antidepressants should be administered cautiously in patients with a history of mania/hypomania.

Cardiovascular Conditions and Disorders

Moderate:

Atapryl

The selegiline in Atapryl has a moderate potential interaction with Cardiovascular Conditions and Disorders.

The use of selegiline has been associated with cardiovascular events such as tachycardia, bradycardia, syncope, hypertension, hypotension, arrhythmias, and aggravation of angina pectoris. Therapy with selegiline should be administered cautiously in patients with cardiac disease.

Dehydration

Moderate:

venlafaxine

Venlafaxine has a moderate potential interaction with Dehydration.

Treatment with SNRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.

Depression

Major:

venlafaxine

Venlafaxine has a major potential interaction with Depression.

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Failure to Thrive

Minor:

venlafaxine

Venlafaxine has a minor potential interaction with Failure to Thrive.

The use of venlafaxine may occasionally cause significant, dose-dependent weight loss, which may be undesirable in patients suffering from anorexia, malnutrition or excessive weight loss. The loss of at least 5% of body weight occurred in 6% to 7% of treated patients in premarketing studies, compared to 1% to 2% for placebo. Anorexia may occur in approximately 10% of patients. Weight change should be monitored during therapy if venlafaxine is used in malnourished or underweight patients.

Glaucoma, Narrow Angle

Moderate:

venlafaxine

Venlafaxine has a moderate potential interaction with Glaucoma, Narrow Angle.

SNRI antidepressants cause pupillary dilation that may trigger an angle closure attack in patients with anatomically narrow angle without iridectomy.

Glaucoma/Intraocular Hypertension

Moderate:

Atapryl

The selegiline in Atapryl has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

The use of selegiline may exacerbate glaucoma. Therapy with selegiline should be administered cautiously in patients with glaucoma.

High Blood Pressure

Moderate:

Atapryl

The selegiline in Atapryl has a moderate potential interaction with High Blood Pressure.

Selegiline can cause hypertensive reactions and it should be used with caution in patients with hypertension. Patients should report any symptoms such as occipital headache, palpitations, neck stiffness or soreness, nausea, sweating, dilated pupils and photophobia. Patients receiving therapy need to have monitored their blood pressure frequently to detect any evidence of pressor response. Additionally, patients should be advised to avoid foods and drinks with high tyramine content such as cheese, sour cream, beer, liver, bananas and others, as these might trigger a hypertensive crisis.

Moderate:

venlafaxine

Venlafaxine has a moderate potential interaction with High Blood Pressure.

Selective serotonin and norepinephrine reuptake inhibitor antidepressants (SNRIs) have been associated with sustained increases in blood pressure. Therapy with SNRI antidepressants should be administered cautiously in patients with preexisting hypertension. Blood pressure should be assessed prior to initiating treatment and monitored regularly. The dose should be reduced or discontinued if necessary.

Hyponatremia

Moderate:

venlafaxine

Venlafaxine has a moderate potential interaction with Hyponatremia.

Treatment with SNRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.

Hypotension

Moderate:

Atapryl

The selegiline in Atapryl has a moderate potential interaction with Hypotension.

Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension at any time, but especially during dose escalation. Additionally, patients with Parkinson's disease may have an impaired capacity to respond to an orthostatic challenge. For these reasons, patients with Parkinson's disease (or restless legs syndrome) who are being treated with dopaminergic agonists typically require careful monitoring for signs/symptoms of orthostatic hypotension, especially during dose escalation, and should be advised of this risk.

Moderate:

Atapryl

The selegiline in Atapryl has a moderate potential interaction with Hypotension.

Hypotension has been observed during therapy with monoamine oxidase inhibitors. These drugs should be used with caution, especially in patients with tendency towards hypotension or taking other drugs known to cause hypotension.

Liver Disease

Major:

venlafaxine

Venlafaxine has a major potential interaction with Liver Disease.

Venlafaxine is metabolized by the liver, and both the parent drug and metabolites are excreted by the kidney. Patients with renal and/or liver disease may be at greater risk for adverse effects from venlafaxine due to decreased drug clearance. Therapy with venlafaxine should be administered cautiously in patients with impaired renal and/or hepatic function. A reduction in the total daily dosage is recommended. The manufacturer suggests a 50% reduction in patients with moderate hepatic impairment (possibly more in patients with cirrhosis), a 25% reduction in patients with mild to moderate renal impairment, and a 50% reduction in patients undergoing hemodialysis (to be administered after dialysis treatment).

Moderate:

Atapryl

The selegiline in Atapryl has a moderate potential interaction with Liver Disease.

Patients with mild to moderate hepatic impairment (Child-Pugh 5 to 9), may require a dose reduction of selegiline depending on their clinical response. Selegiline is not recommended in patients with severe hepatic impairment (Child-Pugh >9).

Malnourishment

Minor:

venlafaxine

Venlafaxine has a minor potential interaction with Malnourishment.

The use of venlafaxine may occasionally cause significant, dose-dependent weight loss, which may be undesirable in patients suffering from anorexia, malnutrition or excessive weight loss. The loss of at least 5% of body weight occurred in 6% to 7% of treated patients in premarketing studies, compared to 1% to 2% for placebo. Anorexia may occur in approximately 10% of patients. Weight change should be monitored during therapy if venlafaxine is used in malnourished or underweight patients.

Mania

Moderate:

venlafaxine

Venlafaxine has a moderate potential interaction with Mania.

All antidepressants may occasionally cause mania or hypomania, particularly in patients with bipolar disorder. Therapy with antidepressants should be administered cautiously in patients with a history of mania/hypomania.

Moderate:

venlafaxine

Venlafaxine has a moderate potential interaction with Mania.

Therapy with SNRI antidepressants can cause activation of mania and hypomania and should be used with caution in patients with personal or family history of mania, hypomania, bipolar disorder, and other mood disorders.

Psychosis

Major:

Atapryl

The selegiline in Atapryl has a major potential interaction with Psychosis.

Patients with major psychotic disorders should ordinarily not be treated with selegiline because of the risk of exacerbating psychosis.

Renal Dysfunction

Major:

Atapryl

The selegiline in Atapryl has a major potential interaction with Renal Dysfunction.

Small increments in serum BUN and creatinine have been observed in patients treated with high dose of selegiline. Treatment with selegiline is not recommended in patients with severe renal impairment and end-stage renal disease (CrCl <30 mL/min).

Major:

venlafaxine

Venlafaxine has a major potential interaction with Renal Dysfunction.

The clearance of SNRI antidepressants is decreased in subjects with renal impairment. SNRIs should be used with caution in this group of patients and a dose adjustment is recommended in those with moderate and severe renal impairment. The use of SNRIs is not recommended in patients with end-stage renal disease.

Major:

venlafaxine

Venlafaxine has a major potential interaction with Renal Dysfunction.

Venlafaxine is metabolized by the liver, and both the parent drug and metabolites are excreted by the kidney. Patients with renal and/or liver disease may be at greater risk for adverse effects from venlafaxine due to decreased drug clearance. Therapy with venlafaxine should be administered cautiously in patients with impaired renal and/or hepatic function. A reduction in the total daily dosage is recommended. The manufacturer suggests a 50% reduction in patients with moderate hepatic impairment (possibly more in patients with cirrhosis), a 25% reduction in patients with mild to moderate renal impairment, and a 50% reduction in patients undergoing hemodialysis (to be administered after dialysis treatment).

Seizures

Moderate:

venlafaxine

Venlafaxine has a moderate potential interaction with Seizures.

SNRI antidepressants may trigger seizures and should be administered with caution in patients with a seizure disorder.

Skin Cancer

Moderate:

Atapryl

The selegiline in Atapryl has a moderate potential interaction with Skin Cancer.

Patients with Parkinson's disease have a higher risk of developing melanoma than the general population. Patients and providers should be advised to monitor for melanoma frequently and regularly when using selegiline. Skin examinations should be performed by qualified individuals (e.g., dermatologists).

Sleep Disorders

Moderate:

Atapryl

The selegiline in Atapryl has a moderate potential interaction with Sleep Disorders.

Selegiline should be used with caution in patients with sleep disorders as it can cause somnolence. Patients should exercise caution when driving, operating machines, or working at heights during treatment. Treatment should be discontinued if patients develop daytime sleepiness with episodes of falling asleep during activities such as conversation, eating, etc. If not discontinued, patients should be very cautious about the activities that they engage in that could be potentially dangerous. Prescribers should question the patients specifically about somnolence, as it is rarely reported by patients, and ask about sleep disorders and the use of concomitant sedating medications.

Urinary Retention

Moderate:

Atapryl

The selegiline in Atapryl has a moderate potential interaction with Urinary Retention.

The use of selegiline may exacerbate urinary retention. Therapy with selegiline should be administered cautiously in patients with urinary retention or obstruction.

Urinary Tract Infection

Moderate:

venlafaxine

Venlafaxine has a moderate potential interaction with Urinary Tract Infection.

SNRI antidepressants have a noradrenergic effect and can affect urethral resistance. Caution should be used in patients with a history of dysuria, prostatic hypertrophy, prostatitis, and other lower urinary tract obstructive disorders.

Urinary Tract Obstruction

Moderate:

venlafaxine

Venlafaxine has a moderate potential interaction with Urinary Tract Obstruction.

SNRI antidepressants have a noradrenergic effect and can affect urethral resistance. Caution should be used in patients with a history of dysuria, prostatic hypertrophy, prostatitis, and other lower urinary tract obstructive disorders.

More resources

Atapryl

A total of 537 drugs are known to interact with Atapryl.

venlafaxine

A total of 727 drugs are known to interact with venlafaxine.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.