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Can you take Quinidine with Tranylcypromine?

1 drug interaction and 41 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

quiNIDine tranylcypromine

Applies to: quinidine and tranylcypromine

Using quiNIDine together with tranylcypromine may increase side effects such as:

  • drowsiness
  • blurred vision
  • dry mouth
  • heat intolerance
  • flushing
  • decreased sweating
  • difficulty urinating
  • abdominal cramping
  • constipation
  • irregular heartbeat
  • confusion
  • memory problems

Side effects may be more likely to occur in the elderly or those with a debilitating condition.

You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect 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.

Food/lifestyle interactions

Major food/lifestyle interactions

Major:

tranylcypromine Food/Lifestyle

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
  • 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
  • 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.

Moderate food/lifestyle interactions

Moderate:

quiNIDine Food/Lifestyle

Applies to: quinidine

Do not consume grapefruit or grapefruit juice during treatment with quiNIDine unless specifically directed otherwise by your doctor.

Grapefruit and grapefruit juice can interact with quiNIDine and increase the levels of quiNIDine in your body.

If you are already consuming grapefruit products, do not increase or decrease the amount of these products in your diet without first talking to your doctor.

Disease interactions

39 potential interactions Applies to: 26 conditions, including Bipolar Disorder, Heart Failure, Headache, Heart Attack, and Angina.

Alcoholism

Major:

tranylcypromine

Tranylcypromine has a major potential interaction with Alcoholism.

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

Angina

Moderate:

tranylcypromine

Tranylcypromine 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.

Bipolar Disorder

Moderate:

tranylcypromine

Tranylcypromine 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.

Moderate:

tranylcypromine

Tranylcypromine 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.

Carcinoid Syndrome

Major:

tranylcypromine

Tranylcypromine 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:

tranylcypromine

Tranylcypromine 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:

tranylcypromine

Tranylcypromine 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).

Cerebral Vascular Disorder

Major:

tranylcypromine

Tranylcypromine 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:

tranylcypromine

Tranylcypromine 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).

Diabetes Mellitus

Moderate:

tranylcypromine

Tranylcypromine 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:

tranylcypromine

Tranylcypromine 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.

Glaucoma/Intraocular Hypertension

Major:

quinidine

quiNIDine has a major potential interaction with Glaucoma/Intraocular Hypertension.

The use of quinidine is contraindicated in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as myasthenia gravis, glaucoma, and urinary retention or obstruction.

Headache

Major:

tranylcypromine

Tranylcypromine 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:

tranylcypromine

Tranylcypromine 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 Block

Major:

quinidine

quiNIDine has a major potential interaction with Heart Block.

The use of quinidine is contraindicated for use in patients without a functioning artificial pacemaker whose cardiac rhythm is dependent upon a junctional or idioventricular pacemaker, including patients with complete AV block. Therapy with quinidine should be administered with caution in patients with severe sinus-node dysfunction such as sick sinus syndrome, bradycardia-tachycardia syndrome, or second- or third-degree heart block.

Heart Failure

Major:

quinidine

quiNIDine has a major potential interaction with Heart Failure.

Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.

Major:

tranylcypromine

Tranylcypromine 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.

Hyperkalemia

Moderate:

quinidine

quiNIDine has a moderate potential interaction with Hyperkalemia.

Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.

Hyperthyroidism

Major:

tranylcypromine

Tranylcypromine 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).

Hypokalemia

Moderate:

quinidine

quiNIDine has a moderate potential interaction with Hypokalemia.

Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.

Hypotension

Major:

quinidine

quiNIDine has a major potential interaction with Hypotension.

Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.

Major:

tranylcypromine

Tranylcypromine 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:

tranylcypromine

Tranylcypromine 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:

tranylcypromine

Tranylcypromine 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.

Major:

tranylcypromine

Tranylcypromine 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.

Moderate:

quinidine

quiNIDine has a moderate potential interaction with Liver Disease.

Quinidine is primarily metabolized by the liver to active and inactive forms. Hepatic dysfunction causes a slowed metabolism and elimination of the drug which can lead to quinidine toxicity if dosage is not appropriately reduced. Clinical monitoring of hepatic function is recommended.

Magnesium Imbalance

Moderate:

quinidine

quiNIDine has a moderate potential interaction with Magnesium Imbalance.

Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.

Mania

Moderate:

tranylcypromine

Tranylcypromine 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.

Myasthenia Gravis

Major:

quinidine

quiNIDine has a major potential interaction with Myasthenia Gravis.

The use of quinidine is contraindicated in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as myasthenia gravis, glaucoma, and urinary retention or obstruction.

Parkinsonism

Moderate:

tranylcypromine

Tranylcypromine 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.

Pheochromocytoma

Major:

tranylcypromine

Tranylcypromine 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:

tranylcypromine

Tranylcypromine 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.

Renal Dysfunction

Major:

tranylcypromine

Tranylcypromine 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.

Moderate:

quinidine

quiNIDine has a moderate potential interaction with Renal Dysfunction.

Renal dysfunction causes a slowed elimination of quinidine which can lead to quinidine toxicity if dosage is not appropriately reduced. Therapy with quinidine should be administered cautiously and dosages reduced in patients with compromised renal function. Quinidine is not appreciably removed by hemodialysis.

Moderate:

tranylcypromine

Tranylcypromine 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:

tranylcypromine

Tranylcypromine 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:

tranylcypromine

Tranylcypromine 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.

Moderate:

tranylcypromine

Tranylcypromine 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.

Urinary Retention

Major:

quinidine

quiNIDine has a major potential interaction with Urinary Retention.

The use of quinidine is contraindicated in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as myasthenia gravis, glaucoma, and urinary retention or obstruction.

More resources

quinidine

A total of 671 drugs are known to interact with quinidine.

tranylcypromine

A total of 551 drugs are known to interact with tranylcypromine.

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.