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Interactions between Isocarboxazid and Relacon-DM

2 drug interactions and 46 additional warnings found for the following 2 drugs:

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Drug interactions

Major drug interactions

Major:

dextromethorphan isocarboxazid

Applies to: Relacon-DM (dextromethorphan / guaifenesin / pseudoephedrine) and isocarboxazid
Contraindicated

By inhibiting serotonin metabolism, monoamine oxidase inhibitors (MAOIs) may potentiate the pharmacologic activity of serotonergic agents such as serotonin reuptake inhibitors, 5-HT1 receptor agonists, ergot alkaloids, buspirone, dextromethorphan, and most antidepressants. The result may be an increased risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.

Management

In general, serotonergic agents should not be used concurrently with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, methylene blue, procarbazine). At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with serotonergic agents. A washout period of 5 to 14 days is usually recommended when switching from another antidepressant to an MAOI; however, the individual product labeling should be consulted.

References (54)
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  2. Schulz R, Antonin KH, Hoffmann E, et al. (1989) "Tyramine kinetics and pressor sensitivity during monoamine oxidase inhibition by selegiline." Clin Pharmacol Ther, 46, p. 528-36
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  4. Sovner R, Wolfe J (1988) "Interaction between dextromethorphan and monoamine oxidase inhibitor therapy with isocarboxazid ." N Engl J Med, 319, p. 1671
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  18. (2001) "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories
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  24. Klysner R, Larsen JK, Sorensen P, Hyllested M, Pedersen BD (1995) "Toxic interaction of venlafaxine and isocarboxazide." Lancet, 346, p. 1298-9
  25. Darcy PF, Griffin JP (1995) "Interactions with drugs used in the treatment of depressive illness." Adverse Drug React Toxicol Rev, 14, p. 211-31
  26. Heisler MA, Guidry JR, Arnecke B (1996) "Serotonin syndrome induced by administration of venlafaxine and phenelzine." Ann Pharmacother, 30, p. 84
  27. De Vita VT, Hahn MA, Oliverio VT (1965) "Monoamine oxidase inhibition by a new carcinostatic agent, n-isopropyl-a-(2-methylhydrazino)-p-toluamide (MIH). (30590)." Proc Soc Exp Biol Med, 120, p. 561-5
  28. Fischer P (1995) "Serotonin syndrome in the elderly after antidepressive monotherapy." J Clin Psychopharmacol, 15, p. 440-2
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  33. Staufenberg EF, Tantam D (1989) "Malignant hyperpyrexia syndrome in combined treatment." Br J Psychiatry, 154, p. 577-8
  34. Levy AB, Bucher P, Votolato N (1985) "Myoclonus, hyperreflexia and diaphoresis in patients on phenelzine- tryptophan combination treatment." Can J Psychiatry, 30, p. 434-6
  35. Beasley CM Jr, Masica DN, Heiligenstein JH, Wheadon DE, Zerbe RL (1993) "Possible monoamine oxidase inhibitor-serotonin uptake inhibitor interaction: fluoxetine clinical data and preclinical findings." J Clin Psychopharmacol, 13, p. 312-20
  36. Mills KC (1997) "Serotonin syndrome: A clinical update." Crit Care Clin, 13, p. 763
  37. Gardner DM, Lynd LD (1998) "Sumatriptan contraindications and the serotonin syndrome." Ann Pharmacother, 32, p. 33-8
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  40. Diamond S, Pepper BJ, Diamond ML, Freitag FG, Urban GJ, Erdemoglu AK (1998) "Serotonin syndrome induced by transitioning from phenelzine to venlafaxine: four patient reports." Neurology, 51, p. 274-6
  41. Chan BSH, Graudins A, Whyte IM, Dawson AH, Braitberg G, Duggin GG (1998) "Serotonin syndrome resulting from drug interactions." Med J Aust, 169, p. 523-5
  42. Brubacher JR, Hoffman RS, Lurin MJ (1996) "Serotonin syndrome from venlafaxine-tranylcypromine interaction." Vet Hum Toxicol, 38, p. 358-61
  43. Miller LG (1998) "Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions." Arch Intern Med, 158, p. 2200-11
  44. Martin TG (1996) "Serotonin syndrome." Ann Emerg Med, 28, p. 520-6
  45. Jacob JE, Wagner ML, Sage JI (2003) "Safety of selegiline with cold medications." Ann Pharmacother, 37, p. 438-41
  46. (2004) "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company
  47. (2005) "Product Information. Manerix (moclobemide)." Hoffmann-La Roche Limited
  48. Gillman PK (2005) "Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity." Br J Anaesth
  49. Bodner RA, Lynch T, Lewis L, Kahn D (1995) "Serotonin syndrome." Neurology, 45, p. 219-23
  50. Jimenez-Genchi A (2006) "Immediate switching from moclobemide to duloxetine may induce serotonin syndrome." J Clin Psychiatry, 67, p. 1821-1822
  51. (2008) "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories
  52. (2009) "Product Information. Savella (milnacipran)." Forest Pharmaceuticals
  53. (2011) "Product Information. Viibryd (vilazodone)." Trovis Pharmaceuticals LLC
  54. (2013) "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals
Major:

pseudoephedrine isocarboxazid

Applies to: Relacon-DM (dextromethorphan / guaifenesin / pseudoephedrine) and isocarboxazid
Contraindicated

Indirect- or mixed-acting sympathomimetic amines may precipitate severe hypertensive reactions and hyperpyrexia in patients treated with monoamine oxidase inhibitors (MAOIs). Death has occurred in some reported cases. The mechanism involves a synergistic sympathomimetic effect due to enhanced norepinephrine storage in adrenergic neurons (MAOI activity) and increased liberation of catecholamines (indirect sympathomimetic activity). Although the interaction has primarily involved nonselective MAOIs, hypertensive crisis has been reported in a patient taking ephedrine with the recommended dosage of a selective MAO-B inhibitor.

Management

In general, indirect- and mixed-acting sympathomimetic agents should not be used concurrently with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, methylene blue, procarbazine). At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with sympathomimetic agents.

References (21)
  1. Pettinger WA, Soyangco FG, Oates JA (1968) "Inhibition of monoamine oxidase in man by furazolidone." Clin Pharmacol Ther, 9, p. 442-7
  2. Schulz R, Antonin KH, Hoffmann E, et al. (1989) "Tyramine kinetics and pressor sensitivity during monoamine oxidase inhibition by selegiline." Clin Pharmacol Ther, 46, p. 528-36
  3. Elis J, Laurence DR, Mattie H, Prichard BN (1967) "Modification by monoamine oxidase inhibitors of the effect of some sympathomimetics on blood pressure." Br Med J, 2, p. 75-8
  4. Davies B, Bannister R, Sever P (1978) "Pressor amines and monoamine-oxidase inhibitors for treatment of postural hypotension in autonomic failure: limitations and hazards." Lancet, 1, p. 172-5
  5. Goldberg LI (1964) "Monoamine oxidase inhibitors: adverse reactions and possible mechanisms." JAMA, 190, p. 456-62
  6. Horler AR, Wynne NA (1965) "Hypertensive crisis due to pargyline and metaraminol." Br Med J, 5459, p. 460-1
  7. Sjoqvist F (1965) "Psychotropic drugs (2) interaction between monoamine oxidase (MAO) inhibitors and other substances." Proc R Soc Med, 58, p. 967-78
  8. Harrison WM, McGrath PJ, Stewart JW, Quitkin F (1989) "MAOIs and hypertensive crises: the role of OTC drugs." J Clin Psychiatry, 50, p. 64-5
  9. Cuthbert MF, Greenberg MP, Morley SW (1969) "Cough and cold remedies: a potential danger to patients on monoamine oxidase inhibitors." Br Med J, 1, p. 404-6
  10. Humberstone PM (1969) "Hypertension from cold remedies." Br Med J, 1, p. 846
  11. Wright SP (1978) "Hazards with monoamine-oxidase inhibitors: a persistent problem." Lancet, 1, p. 284-5
  12. Schildkraut JJ, Klerman GL, Friend DG, Greenblatt M (1963) "Biochemical and pressor effects of oral d,l-dihydroxyphenylalanine in patients pretreated with antidepressant drugs." Ann N Y Acad Sci, 107, p. 1005-15
  13. Smookler S, Bermudez AJ (1982) "Hypertensive crisis resulting from an MAO inhibitor and an over-the-counter appetite suppressant." Ann Intern Med, 11, p. 482-4
  14. Mason AM, Buckle RM (1969) ""Cold" cures and monoamine-oxidase inhibitors." Br Med J, 1, p. 845-6
  15. Boakes AJ, Laurence DR, Teoh PC, Barar FS, Benedikter LT, Prichard BN (1973) "Interactions between sympathomimetic amines and antidepressant agents in man." Br Med J, 1, p. 311-5
  16. Goulet JP, Perusse R, Turcotte JY (1992) "Contraindications to vasoconstrictors in dentistry: Part III. Pharmacologic interactions." Oral Surg Oral Med Oral Pathol, 74, p. 692-7
  17. Ban TA (1975) "Drug interactions with psychoactive drugs." Dis Nerv Syst, 36, p. 164-6
  18. Lefebvre H, Noblet C, Morre N, Wolf LM (1995) "Pseudo-phaeochromocytoma after multiple drug interactions involving the selective monoamine oxidase inhibitor selegiline." Clin Endocrinol (Oxf), 42, p. 95-8
  19. Darcy PF, Griffin JP (1995) "Interactions with drugs used in the treatment of depressive illness." Adverse Drug React Toxicol Rev, 14, p. 211-31
  20. De Vita VT, Hahn MA, Oliverio VT (1965) "Monoamine oxidase inhibition by a new carcinostatic agent, n-isopropyl-a-(2-methylhydrazino)-p-toluamide (MIH). (30590)." Proc Soc Exp Biol Med, 120, p. 561-5
  21. Kraft KE, Dore FH (1996) "Computerized drug interaction programs: how reliable?." JAMA, 275, p. 1087

Food/lifestyle interactions

Major food/lifestyle interactions

Major:

isocarboxazid Food/Lifestyle

Applies to: isocarboxazid
Contraindicated

Foods that contain large amounts of tyramine may precipitate a hypertensive crisis in patients treated with monoamine oxidase inhibitors (MAOIs). The mechanism is inhibition of MAO-A, the enzyme responsible for metabolizing exogenous amines such as tyramine in the gut and preventing them from being absorbed intact. Once absorbed, tyramine is metabolized to octopamine, a substance that is believed to displace norepinephrine from storage granules.

Generally avoid

Alcohol may potentiate some of the pharmacologic effects of MAOIs. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

Management

In general, patients treated with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, linezolid, procarbazine) should avoid consumption of products that contain large amounts of amines and protein foods in which aging or breakdown of protein is used to increase flavor. These foods include cheese (particularly strong, aged or processed cheeses), sour cream, wine (particularly red wine), champagne, beer, pickled herring, anchovies, caviar, shrimp paste, liver (particularly chicken liver), dry sausage, salamis, figs, raisins, bananas, avocados, chocolate, soy sauce, bean curd, sauerkraut, yogurt, papaya products, meat tenderizers, fava bean pods, protein extracts, yeast extracts, and dietary supplements. Caffeine may also precipitate hypertensive crisis so its intake should be minimized as well. At least 14 days should elapse following discontinuation of MAOI therapy before these foods may be consumed. Specially designed reference materials and dietary consultation are recommended so that an appropriate and safe diet can be planned. Patients should be advised to promptly seek medical attention if they experience potential signs and symptoms of a hypertensive crisis such as severe headache, visual disturbances, difficulty thinking, stupor or coma, seizures, chest pain, unexplained nausea or vomiting, and stroke-like symptoms. Patients should also be counseled not to use MAOIs with alcohol, and to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them.

References (19)
  1. Pettinger WA, Soyangco FG, Oates JA (1968) "Inhibition of monoamine oxidase in man by furazolidone." Clin Pharmacol Ther, 9, p. 442-7
  2. Goldberg LI (1964) "Monoamine oxidase inhibitors: adverse reactions and possible mechanisms." JAMA, 190, p. 456-62
  3. Nuessle WF, Norman FC, Miller HE (1965) "Pickled herring and tranylcypromine reaction." JAMA, 192, p. 142-3
  4. Sweet RA, Liebowitz MR, Holt CS, Heimberg RG (1991) "Potential interactions between monoamine oxidase inhibitors and prescribed dietary supplements." J Clin Psychopharmacol, 11, p. 331-2
  5. Walker JI, Davidson J, Zung WWK (1984) "Patient compliance with MAO Inhibitor therapy." J Clin Psychiatry, 45, p. 78-80
  6. Ban TA (1975) "Drug interactions with psychoactive drugs." Dis Nerv Syst, 36, p. 164-6
  7. Darcy PF, Griffin JP (1995) "Interactions with drugs used in the treatment of depressive illness." Adverse Drug React Toxicol Rev, 14, p. 211-31
  8. Maxwell MB (1980) "Reexamining the dietary restrictions with procarbazine (an MAOI)." Cancer Nurs, 3, p. 451-7
  9. (2001) "Product Information. Matulane (procarbazine)." Roche Laboratories
  10. De Vita VT, Hahn MA, Oliverio VT (1965) "Monoamine oxidase inhibition by a new carcinostatic agent, n-isopropyl-a-(2-methylhydrazino)-p-toluamide (MIH). (30590)." Proc Soc Exp Biol Med, 120, p. 561-5
  11. Zetin M, Plon L, DeAntonio M (1987) "MAOI reaction with powdered protein dietary supplement." J Clin Psychiatry, 48, p. 499
  12. Domino EF, Selden EM (1984) "Red wine and reactions." J Clin Psychopharmacol, 4, p. 173-4
  13. Tailor SA, Shulman KI, Walker SE, Moss J, Gardner D (1994) "Hypertensive episode associated with phenelzine and tap beer--a reanalysis of the role of pressor amines in beer." J Clin Psychopharmacol, 14, p. 5-14
  14. Pohl R, Balon R, Berchou R (1988) "Reaction to chicken nuggets in a patient taking an MAOI." Am J Psychiatry, 145, p. 651
  15. (2001) "Product Information. Furoxone (furazolidone)." Roberts Pharmaceutical Corporation
  16. (2001) "Product Information. Nardil (phenelzine)." Parke-Davis
  17. (2001) "Product Information. Marplan (isocarboxazid)." Roche Laboratories
  18. (2001) "Product Information. Zyvox (linezolid)." Pharmacia and Upjohn
  19. Martin TG (1996) "Serotonin syndrome." Ann Emerg Med, 28, p. 520-6

Moderate food/lifestyle interactions

Moderate:

dextromethorphan Food/Lifestyle

Applies to: Relacon-DM (dextromethorphan / guaifenesin / pseudoephedrine)
Generally avoid

Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

Management

Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References (4)
  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka America Pharmaceutical, Inc.
Moderate:

pseudoephedrine Caffeine

Applies to: Relacon-DM (dextromethorphan / guaifenesin / pseudoephedrine)
Monitor

Coadministration of two or more sympathomimetic or noradrenergic agents may increase the risk of nervousness, irritability, tachycardia, and/or increased blood pressure. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic and/or noradrenergic agents, including norepinephrine transporter inhibitors. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

Management

Caution is advised if two or more sympathomimetic or noradrenergic agents are coadministered. Pulse and blood pressure should be closely monitored. Consultation with individual product labeling, as well as relevant institutional protocols, may be advisable for further guidance.

References (20)
  1. Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr (1979) "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res, 1, p. 45-52
  2. Cavanaugh JH, Griffith JD, Oates JA (1970) "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther, 11, p. 656
  3. (2001) "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc
  4. (2001) "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals
  5. (2001) "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals
  6. (2001) "Product Information. Focalin (dexmethylphenidate)." Mikart Inc
  7. (2024) "Product Information. Ephedrine (ephedrine)." Hameln Pharma Ltd
  8. (2023) "Product Information. Ephedrine Hydrochloride (ephedrine)." Wockhardt UK Ltd
  9. (2026) "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company
  10. (2025) "Product Information. Atomoxetine (atomoxetine)." Zentiva Pharma UK Ltd
  11. (2026) "Product Information. Atomoxetine (Apo) (atomoxetine)." Arrotex Pharmaceuticals Pty Ltd
  12. Angita Pharma, Inc (2026) AG-ATOMOXETINE Product Monograph (Health Canada) https://pdf.hres.ca/dpd_pm/00059014.PDF
  13. (2026) "Product Information. Boots Decongestant (Pseudoephedrine) (pseudoephedrine)." The Boots Company Plc
  14. (2023) "Product Information. Sinus and Nasal Decongestant (Trust) (pseudoephedrine)." Noumed Pharmaceuticals Pty Ltd
  15. (2019) "Product Information. Ephedrine (ephedrine)." Pfizer Australia Pty Ltd
  16. (2024) "Product Information. EPHEDrine Sulfate (ePHEDrine)." Amneal Pharmaceuticals LLC
  17. (2024) "Product Information. Lemsip Cough Max for Mucus Cough and Cold (guaifenesin/paracetamol/phenylephrine)." Reckitt Benckiser Healthcare (UK) Ltd
  18. emc (2026) Product information: sudafed plus blocked nose 1mg/50mg/ml nasal spray. https://www.medicines.org.uk/emc/product/14256/smpc?utm_source=chatgpt.com
  19. (2023) "Product Information. EPHEDrine Sulfate (ePHEDrine)." Baxter Corporation
  20. Neo Health (OTC) Pty Ltd (2026) Product information: pseudoephedrine hydrochloride-paracetamol capsules. https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2024-PI-02603-1&d=20260804172310101&d=20260827172310101

Disease interactions

43 potential interactions Applies to: 25 conditions, including Bipolar Disorder, Heart Failure, Benign Prostatic Hyperplasia, Headache, and Heart Attack.

Alcoholism

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Alcoholism.

The use of monoamine oxidase inhibitors with alcohol or any other CNS depressants is contraindicated.

Angina

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Angina.

Monoamine oxidase inhibitors may have the capacity to suppress anginal pain that would otherwise serve as a warning of myocardial ischemia. Caution is advised in patients with a history of angina or risk of myocardial infarction.

Benign Prostatic Hyperplasia

Moderate:

Relacon-DM

The pseudoephedrine in Relacon-DM has a moderate potential interaction with Benign Prostatic Hyperplasia.

Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.

Bipolar Disorder

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Bipolar Disorder.

Monoamine oxidase inhibitor (MAOI) antidepressants may cause excessive stimulation in hyperactive or schizophrenic patients. Symptoms of psychosis may be aggravated in schizophrenia, particularly that with paranoid symptomatology. Depressed patients, usually those with bipolar disorder, may experience a switch from depression to mania or hypomania. Therapy with MAOI antidepressants should be administered cautiously in patients with hyperactive or hyperexcitable personalities, schizophrenia or bipolar disorder.

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Bipolar Disorder.

A major depressive episode can be the initial presentation of bipolar disorder. Patients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder prior to initiating treatment with a monoamine oxidase inhibitor (MAOI). This screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression. It should be noted that MAOIs antidepressants are not approved for use in treating bipolar depression.

Carcinoid Syndrome

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Carcinoid Syndrome.

The use of nonspecific monoamine oxidase inhibitors (MAOIs) is contraindicated in patients with carcinoid syndrome. Nonspecific MAOIs inhibit the breakdown of pressor amines, including serotonin, and may exacerbate symptoms of the syndrome.

Cardiovascular Conditions and Disorders

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Cardiovascular Conditions and Disorders.

The use of most monoamine oxidase inhibitors (MAOIs) is contraindicated in patients with diagnosed cardiovascular disease, hypertension, or confirmed or suspected cerebrovascular disorders. These drugs can cause hypertensive crises, which sometimes can be fatal, and are characterized by occipital headache, palpitations, neck stiffness or soreness, nausea, sweating, dilated pupils and photophobia. Intracranial bleeding has been reported in some cases in association with the increase in blood pressure.

Normotensive patients receiving therapy with MAOIs need to have monitored their blood pressure frequently to detect any evidence of pressor response and treatment should be discontinued immediately if blood pressure increases or the patient reports symptoms such a headaches or palpitations. 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 an hypertensive crisis.

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Cardiovascular Conditions and Disorders.

The use of monoamine oxidase inhibitor (MAOI) antidepressants is contraindicated in patients with cerebrovascular or cardiovascular disease, including hypertension and congestive heart failure. Nonspecific MAOIs inhibit the breakdown of pressor amines, the accumulation of which can precipitate hypertensive crises. Intracranial hemorrhage and death have resulted in some cases. MAOI antidepressants are also commonly associated with dose-related orthostatic hypotension, which occurs most frequently in patients with preexisting hypertension but may be minimized with slow, gradual titration. Blood pressure should be monitored closely in all patients who receive MAOI therapy, and patients should be advised to stop taking the medication and seek medical attention immediately if signs and symptoms of a hypertensive reaction occur (e.g., occipital headache which may radiate frontally; palpitation; neck stiffness or soreness; nausea or vomiting; perspiration associated with fever or cold, clammy skin; mydriasis; photophobia; constricting chest pain).

Major:

Relacon-DM

The pseudoephedrine in Relacon-DM has a major potential interaction with Cardiovascular Conditions and Disorders.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

Cerebral Vascular Disorder

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Cerebral Vascular Disorder.

The use of most monoamine oxidase inhibitors (MAOIs) is contraindicated in patients with diagnosed cardiovascular disease, hypertension, or confirmed or suspected cerebrovascular disorders. These drugs can cause hypertensive crises, which sometimes can be fatal, and are characterized by occipital headache, palpitations, neck stiffness or soreness, nausea, sweating, dilated pupils and photophobia. Intracranial bleeding has been reported in some cases in association with the increase in blood pressure.

Normotensive patients receiving therapy with MAOIs need to have monitored their blood pressure frequently to detect any evidence of pressor response and treatment should be discontinued immediately if blood pressure increases or the patient reports symptoms such a headaches or palpitations. 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 an hypertensive crisis.

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Cerebral Vascular Disorder.

The use of monoamine oxidase inhibitor (MAOI) antidepressants is contraindicated in patients with cerebrovascular or cardiovascular disease, including hypertension and congestive heart failure. Nonspecific MAOIs inhibit the breakdown of pressor amines, the accumulation of which can precipitate hypertensive crises. Intracranial hemorrhage and death have resulted in some cases. MAOI antidepressants are also commonly associated with dose-related orthostatic hypotension, which occurs most frequently in patients with preexisting hypertension but may be minimized with slow, gradual titration. Blood pressure should be monitored closely in all patients who receive MAOI therapy, and patients should be advised to stop taking the medication and seek medical attention immediately if signs and symptoms of a hypertensive reaction occur (e.g., occipital headache which may radiate frontally; palpitation; neck stiffness or soreness; nausea or vomiting; perspiration associated with fever or cold, clammy skin; mydriasis; photophobia; constricting chest pain).

Cerebrovascular Insufficiency

Major:

Relacon-DM

The pseudoephedrine in Relacon-DM has a major potential interaction with Cerebrovascular Insufficiency.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

Diabetes Mellitus

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Diabetes Mellitus.

There is conflicting evidence regarding whether monoamine oxidase inhibitors (MAOIs) affect glucose metabolism or potentiate oral hypoglycemic agents. Therapy with MAOIs should be administered cautiously in patients with diabetes.

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Diabetes Mellitus.

Monoamine oxidase inhibitors can increase the sensitivity to insulin, and have contributed to hypoglycemic episodes in patients with diabetes. Caution should be used when prescribing in diabetic patients.

Moderate:

Relacon-DM

The pseudoephedrine in Relacon-DM has a moderate potential interaction with Diabetes Mellitus.

Sympathomimetic agents may cause increases in blood glucose concentrations. These effects are usually transient and slight but may be significant with dosages higher than those normally recommended. Therapy with sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate.

Gastrointestinal Obstruction

Moderate:

Relacon-DM

The pseudoephedrine in Relacon-DM has a moderate potential interaction with Gastrointestinal Obstruction.

The extended-release formulation of pseudoephedrine (Sudafed 24 Hour) contains a non-deformable material. There have been rare reports of obstructive symptoms in patients with known strictures following the ingestion of similar sustained-release products. Therapy with the extended-release formulation of pseudoephedrine should be administered cautiously in patients with preexisting severe gastrointestinal narrowing or obstruction, whether pathologic or iatrogenic.

Glaucoma/Intraocular Hypertension

Moderate:

Relacon-DM

The pseudoephedrine in Relacon-DM has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Sympathomimetic agents can induce transient mydriasis via stimulation of alpha-1 adrenergic receptors. In patients with anatomically narrow angles or narrow-angle glaucoma, pupillary dilation can provoke an acute attack. In patients with other forms of glaucoma, mydriasis may occasionally increase intraocular pressure. Therapy with sympathomimetic agents should be administered cautiously in patients with or predisposed to glaucoma, particularly narrow-angle glaucoma.

Headache

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Headache.

The use of monoamine oxidase inhibitor (MAOI) antidepressants is contraindicated in patients with a history of headaches. Nonspecific MAOIs inhibit the breakdown of pressor amines, the accumulation of which can precipitate hypertensive crises. Intracranial hemorrhage and death have resulted in some cases. Since headache may often be the first symptom of a hypertensive reaction during MAOI therapy, use of these agents is not recommended in patients who experience frequent or severe headaches. MAOIs should be withdrawn promptly if headaches develop during treatment.

Heart Attack

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Heart Attack.

Monoamine oxidase inhibitors may have the capacity to suppress anginal pain that would otherwise serve as a warning of myocardial ischemia. Caution is advised in patients with a history of angina or risk of myocardial infarction.

Heart Failure

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Heart Failure.

The use of most monoamine oxidase inhibitors (MAOIs) is contraindicated in patients with diagnosed cardiovascular disease, hypertension, or confirmed or suspected cerebrovascular disorders. These drugs can cause hypertensive crises, which sometimes can be fatal, and are characterized by occipital headache, palpitations, neck stiffness or soreness, nausea, sweating, dilated pupils and photophobia. Intracranial bleeding has been reported in some cases in association with the increase in blood pressure.

Normotensive patients receiving therapy with MAOIs need to have monitored their blood pressure frequently to detect any evidence of pressor response and treatment should be discontinued immediately if blood pressure increases or the patient reports symptoms such a headaches or palpitations. 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 an hypertensive crisis.

Hyperthyroidism

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Hyperthyroidism.

Nonspecific monoamine oxidase inhibitors (MAOIs) inhibit the breakdown of pressor amines, the accumulation of which can precipitate hypertensive crises. Intracranial hemorrhage and death have resulted in some cases. Therapy with nonspecific MAOIs should be administered cautiously in patients with hyperthyroidism, since these patients have an increased sensitivity to pressor amines. Blood pressure should be monitored closely during therapy, and patients should be advised to stop taking the medication and seek medical attention immediately if signs and symptoms of a hypertensive reaction occur (e.g., occipital headache which may radiate frontally; palpitation; neck stiffness or soreness; nausea or vomiting; perspiration associated with fever or cold, clammy skin; mydriasis; photophobia; constricting chest pain).

Major:

Relacon-DM

The pseudoephedrine in Relacon-DM has a major potential interaction with Hyperthyroidism.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Hyperthyroidism.

Isocarboxazid should be used with caution in hyperthyroid patients because of their increased sensitivity to pressor amines.

Hypotension

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Hypotension.

The use of monoamine oxidase inhibitor (MAOI) antidepressants is contraindicated in patients with cerebrovascular or cardiovascular disease, including hypertension and congestive heart failure. Nonspecific MAOIs inhibit the breakdown of pressor amines, the accumulation of which can precipitate hypertensive crises. Intracranial hemorrhage and death have resulted in some cases. MAOI antidepressants are also commonly associated with dose-related orthostatic hypotension, which occurs most frequently in patients with preexisting hypertension but may be minimized with slow, gradual titration. Blood pressure should be monitored closely in all patients who receive MAOI therapy, and patients should be advised to stop taking the medication and seek medical attention immediately if signs and symptoms of a hypertensive reaction occur (e.g., occipital headache which may radiate frontally; palpitation; neck stiffness or soreness; nausea or vomiting; perspiration associated with fever or cold, clammy skin; mydriasis; photophobia; constricting chest pain).

Moderate:

isocarboxazid

Isocarboxazid 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:

isocarboxazid

Isocarboxazid has a major potential interaction with Liver Disease.

The use of monoamine oxidase inhibitor (MAOI) antidepressants is contraindicated in patients with abnormal liver function tests or a history of liver disease. A low incidence of altered liver function or hepatocellular jaundice has been reported in association with the use of MAOI antidepressants. Periodic monitoring of liver function tests is recommended during prolonged and/or high-dose therapy.

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Liver Disease.

The use of monoamine oxidase inhibitors is contraindicated in patients with a history of liver disease or in those with abnormal liver function tests.

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Liver Disease.

There has been a low incidence of altered liver function and jaundice in patients receiving isocarboxazid. This drug should be used with caution in patients with any history of liver disease. Periodic liver chemistry tests should be performed during therapy and the use of the drug should be discontinued at the fist sign of hepatic dysfunction or jaundice.

Mania

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Mania.

Monoamine oxidase inhibitor (MAOI) antidepressants may cause excessive stimulation in hyperactive or schizophrenic patients. Symptoms of psychosis may be aggravated in schizophrenia, particularly that with paranoid symptomatology. Depressed patients, usually those with bipolar disorder, may experience a switch from depression to mania or hypomania. Therapy with MAOI antidepressants should be administered cautiously in patients with hyperactive or hyperexcitable personalities, schizophrenia or bipolar disorder.

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Mania.

Some monoamine oxidase inhibitors such as isocarboxazid and phenelzine, should be used cautiously in hyperactive and agitated patients, as well as schizophrenic patients, as these may cause excessive stimulation. Additionally, activation of mania/hypomania has been reported in a small portion of patients with major affective disorders.

Parkinsonism

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Parkinsonism.

Nonspecific monoamine oxidase inhibitors (MAOIs) may increase the frequency and severity of signs and symptoms associated with parkinsonian syndrome. Therapy with nonspecific MAOIs should be administered cautiously in patients with this disorder.

Phenylketonuria

Moderate:

Relacon-DM

The pseudoephedrine in Relacon-DM has a moderate potential interaction with Phenylketonuria.

Chewable products frequently may contain aspartame, which is metabolized in the gastrointestinal tract to phenylalanine. Sudafed (brand of pseudoephedrine) chewable 15 mg tablets provide the equivalent of 0.78 mg of phenylalanine per each tablet. The aspartame/phenylalanine content should be considered when this and similar products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

Pheochromocytoma

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Pheochromocytoma.

The use of most monoamine oxidase inhibitors (MAOIs) is contraindicated in patients with pheochromocytoma, as such tumors secrete pressor substances whose metabolism may be inhibited by these drugs.

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Pheochromocytoma.

The use of nonspecific monoamine oxidase inhibitors (MAOIs) is contraindicated in patients with pheochromocytoma or other tumors of the adrenal medulla, such as some neuroblastomas, that secrete pressor substances. Nonspecific MAOIs inhibit the breakdown of pressor amines, the accumulation of which can precipitate hypertensive crises. Intracranial hemorrhage and death have resulted in some cases.

Major:

Relacon-DM

The pseudoephedrine in Relacon-DM has a major potential interaction with Pheochromocytoma.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

Prostate Tumor, Benign

Moderate:

Relacon-DM

The pseudoephedrine in Relacon-DM has a moderate potential interaction with Prostate Tumor, Benign.

Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.

Renal Dysfunction

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Renal Dysfunction.

The use of monoamine oxidase inhibitor (MAOI) antidepressants is contraindicated in patients with severe renal dysfunction. These drugs may accumulate in plasma when renal function is impaired.

Major:

isocarboxazid

Isocarboxazid has a major potential interaction with Renal Dysfunction.

The use of some monoamine oxidase inhibitors such as isocarboxazid and phenelzine, is contraindicated in patients with severe renal impairment.

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Renal Dysfunction.

Monoamine oxidase inhibitors should be used with caution in patients with renal impairment as there is a possibility of cumulative effects in such patients. Dose selection should be cautious, usually starting at the low end of the dosing range.

Schizophrenia

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Schizophrenia.

Some monoamine oxidase inhibitors such as isocarboxazid and phenelzine, should be used cautiously in hyperactive and agitated patients, as well as schizophrenic patients, as these may cause excessive stimulation. Additionally, activation of mania/hypomania has been reported in a small portion of patients with major affective disorders.

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Schizophrenia.

Monoamine oxidase inhibitor (MAOI) antidepressants may cause excessive stimulation in hyperactive or schizophrenic patients. Symptoms of psychosis may be aggravated in schizophrenia, particularly that with paranoid symptomatology. Depressed patients, usually those with bipolar disorder, may experience a switch from depression to mania or hypomania. Therapy with MAOI antidepressants should be administered cautiously in patients with hyperactive or hyperexcitable personalities, schizophrenia or bipolar disorder.

Seizures

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Seizures.

Monoamine oxidase inhibitor (MAOI) antidepressants may have variable effects on seizure threshold. Decreased seizure frequency as well as increased frequency have been reported. Therapy with MAOI antidepressants should be administered cautiously in patients with a history of seizures.

Moderate:

isocarboxazid

Isocarboxazid has a moderate potential interaction with Seizures.

Monoamine oxidase inhibitors have shown a variable effect on the convulsive threshold. Caution should be used when treating patients with epilepsy.

More resources

isocarboxazid

A total of 552 drugs are known to interact with isocarboxazid.

Relacon-DM

A total of 544 drugs are known to interact with Relacon-DM.

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.