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Drug Interactions between Etrafon Forte and tranylcypromine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

amitriptyline tranylcypromine

Applies to: Etrafon Forte (amitriptyline / perphenazine) and tranylcypromine

Using tranylcypromine together with amitriptyline 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 tranylcypromine before you start treatment with amitriptyline. Conversely, if you have recently been on amitriptyline and are now starting treatment with tranylcypromine, you should check with your doctor or pharmacist to see how long you should wait before it is safe for you to use tranylcypromine, 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.

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Moderate

amitriptyline perphenazine

Applies to: Etrafon Forte (amitriptyline / perphenazine) and Etrafon Forte (amitriptyline / perphenazine)

Before taking amitriptyline, tell your doctor if you also use perphenazine. You may need dose adjustments or special tests in order to safely take both medications together. This combination should be used with caution, particularly in the elderly. You should notify your doctor promptly if you have signs of bladder problems, dry mouth, stomach pain, fever, blurred vision, confusion, dizziness, or reduced heart rate. You should avoid driving until you know how these medications will affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using your medications without first talking to your doctor.

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Moderate

perphenazine tranylcypromine

Applies to: Etrafon Forte (amitriptyline / perphenazine) and tranylcypromine

Using perphenazine together with tranylcypromine can increase the side effects of both medications. You may be more likely to develop low blood pressure and related problems such as dizziness, lightheadedness, fainting, weakness, and a rapid pulse/heart rate. Nervous system side effects such as drowsiness, confusion, disorientation, memory loss, and seizures may also increase. Let your doctor know if you experience these symptoms and they do not go away after a few days or they become troublesome. These side effects can occur with either medication alone and are most often seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Alcohol may also increase these effects, so you should avoid the consumption of alcohol during treatment with these medications. You should seek immediate medical attention if you develop fever, muscle stiffness, confusion, sweating, fast or uneven heartbeats, restless muscle movements in your face or neck, tremor (uncontrolled shaking), or difficulty swallowing. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. 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.

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Drug and food interactions

Major

tranylcypromine food

Applies to: tranylcypromine

During and within two weeks after treatment with tranylcypromine, you must not consume any foods or beverages that are high in tyramine content. Doing so can raise your blood pressure to dangerous levels, a condition known as hypertensive crisis. The condition is potentially fatal and may cause symptoms such as severe headache, confusion, blurred vision, problems with speech or balance, nausea, vomiting, chest pain, convulsions, and sudden numbness or weakness (especially on one side of the body). You should seek immediate medical attention if you have any of these symptoms. Foods that are high in tyramine include, but are not limited to, air dried meats; aged or fermented meats; sausage or salami; pickled herring; anchovies; liver; red wine; beer; aged cheeses, including blue, brick, brie, cheddar, parmesan, romano, and swiss; sour cream; sauerkraut; canned figs; raisins; bananas or avocados (particularly if overripe); soy beans; soy sauce; tofu; miso soup; bean curd; fava beans; or yeast extracts (such as Marmite). You should avoid the use of alcohol while being treated with tranylcypromine, as alcohol may increase some of the nervous system side effects such as dizziness, drowsiness, and difficulty concentrating. Also 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.

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Moderate

amitriptyline food

Applies to: Etrafon Forte (amitriptyline / perphenazine)

Ask your doctor before using amitriptyline together with ethanol, this can alter the effects of amitriptyline and cause increased side effects. Call the doctor if you experience uneven heartbeats, extreme drowsiness, confusion, agitation, vomiting, blurred vision, sweating, muscle stiffness, feeling light-headed, and seizures. You should be warned not to exceed recommended dosages, to avoid alcohol, and to avoid activities requiring mental alertness. If your doctor prescribes these medications together, you may need a dose adjustment to safely take this combination. 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.

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Moderate

perphenazine food

Applies to: Etrafon Forte (amitriptyline / perphenazine)

Ask your doctor before using perphenazine together with ethanol. This can cause uncontrollable movements, agitation, seizures, severe dizziness or fainting, coma, very deep sleep, irregular heartbeats, and high or low body temperature. Use caution when driving, operating machinery, or performing other hazardous activities, these medicaions may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. 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.

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Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Antidepressants

Therapeutic duplication

The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antidepressants' category:

  • Etrafon Forte (amitriptyline/perphenazine)
  • tranylcypromine

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.


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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.