Interactions between Timoptic Ocudose and Tranylcypromine
1 drug interaction and 41 additional warnings found for the following 2 drugs:
- Timoptic Ocudose (timolol ophthalmic)
- tranylcypromine
Drug interactions
Moderate drug interactions
Moderate:
tranylcypromine timolol ophthalmic
Applies to: tranylcypromine and Timoptic Ocudose (timolol ophthalmic)
Monitor
Sympathetic ganglion-blocking or catecholamine-depleting agents such as guanethidine, reserpine, and monoamine oxidase (MAO) inhibitors may potentiate the pharmacologic effects of beta-blockers, which are thought to competitively antagonize catecholamines at cardiac and other peripheral adrenergic neurons. Combining these medications may increase the risk of hypotension, orthostasis, bradycardia, and heart failure due to excessive reduction of sympathetic activity. A case report describes two elderly patients who developed bradycardia less than 2 weeks after the initiation of phenelzine during treatment with a beta-blocker (nadolol 40 mg/day or metoprolol 150 mg/day). The pulse rates returned to normal following a 50% reduction of the nadolol dosage and discontinuation of metoprolol. In another report, a young woman developed marked orthostatic hypotension following the addition of pindolol 2.5 mg three times a day to an existing regimen of tranylcypromine. The pindolol dosage was reduced to 2.5 mg twice a day until her blood pressure stabilized, then slowly increased to 5 mg three times a day.
Management
Caution is advised if beta-blockers, including ophthalmic formulations, are prescribed in combination with sympathetic ganglion-blocking or catecholamine-depleting agents. Patients should contact their doctor if they experience dizziness, lightheadedness, syncope, bradycardia, shortness of breath, difficulty breathing, edema, and/or chest pain.
References (13)
- Reggev A, Vollhardt BR (1989) "Bradycardia induced by an interaction between phenelzine and beta blockers." Psychosomatics, 30, p. 106-8
- Pettinger WA, Soyangco FG, Oates JA (1968) "Inhibition of monoamine oxidase in man by furazolidone." Clin Pharmacol Ther, 9, p. 442-7
- Goldberg LI (1964) "Monoamine oxidase inhibitors: adverse reactions and possible mechanisms." JAMA, 190, p. 456-62
- (2001) "Product Information. Hylorel (guanadrel)." Rhone Poulenc Rorer
- (2001) "Product Information. Matulane (procarbazine)." Roche Laboratories
- 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
- Kronig MH, Roose SP, Walsh BT, Woodring S, Glassman AH (1983) "Blood pressure effects of phenelzine." J Clin Psychopharmacol, 3, p. 307-10
- Golwyn DH, Sevlie CP (1993) "Monoamine oxidase inhibitor hypertensive crisis headache and orthostatic hypotension." J Clin Psychopharmacol, 13, p. 77-8
- (2001) "Product Information. Nardil (phenelzine)." Parke-Davis
- (2001) "Product Information. Parnate (tranylcypromine)." SmithKline Beecham
- (2001) "Product Information. Marplan (isocarboxazid)." Roche Laboratories
- (2001) "Product Information. Toprol-XL (metoprolol)." Astra-Zeneca Pharmaceuticals
- Kraus RP (1997) "Pindolol augmentation of tranylcypromine in psychotic depression." J Clin Psychopharmacol, 17, p. 225-6
Food/lifestyle interactions
Major food/lifestyle interactions
Major:
tranylcypromine Food/Lifestyle
Applies to: tranylcypromine
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)
- Pettinger WA, Soyangco FG, Oates JA (1968) "Inhibition of monoamine oxidase in man by furazolidone." Clin Pharmacol Ther, 9, p. 442-7
- Goldberg LI (1964) "Monoamine oxidase inhibitors: adverse reactions and possible mechanisms." JAMA, 190, p. 456-62
- Nuessle WF, Norman FC, Miller HE (1965) "Pickled herring and tranylcypromine reaction." JAMA, 192, p. 142-3
- 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
- Walker JI, Davidson J, Zung WWK (1984) "Patient compliance with MAO Inhibitor therapy." J Clin Psychiatry, 45, p. 78-80
- Ban TA (1975) "Drug interactions with psychoactive drugs." Dis Nerv Syst, 36, p. 164-6
- Darcy PF, Griffin JP (1995) "Interactions with drugs used in the treatment of depressive illness." Adverse Drug React Toxicol Rev, 14, p. 211-31
- Maxwell MB (1980) "Reexamining the dietary restrictions with procarbazine (an MAOI)." Cancer Nurs, 3, p. 451-7
- (2001) "Product Information. Matulane (procarbazine)." Roche Laboratories
- 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
- Zetin M, Plon L, DeAntonio M (1987) "MAOI reaction with powdered protein dietary supplement." J Clin Psychiatry, 48, p. 499
- Domino EF, Selden EM (1984) "Red wine and reactions." J Clin Psychopharmacol, 4, p. 173-4
- 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
- Pohl R, Balon R, Berchou R (1988) "Reaction to chicken nuggets in a patient taking an MAOI." Am J Psychiatry, 145, p. 651
- (2001) "Product Information. Furoxone (furazolidone)." Roberts Pharmaceutical Corporation
- (2001) "Product Information. Nardil (phenelzine)." Parke-Davis
- (2001) "Product Information. Marplan (isocarboxazid)." Roche Laboratories
- (2001) "Product Information. Zyvox (linezolid)." Pharmacia and Upjohn
- Martin TG (1996) "Serotonin syndrome." Ann Emerg Med, 28, p. 520-6
Disease interactions
40 potential interactions Applies to: 28 conditions, including Allergies, Bipolar Disorder, Heart Failure, Asthma, and Headache.
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.
Allergies
Major:
Timoptic Ocudose
The timolol ophthalmic in Timoptic Ocudose has a major potential interaction with Allergies.
Topically applied beta-adrenergic receptor blocking agents (aka beta-blockers) are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. The use of beta-blockers in patients with a history of allergic reactions or anaphylaxis may be associated with heightened reactivity to culprit allergens. The frequency and/or severity of attacks may be increased during beta-blocker therapy. In addition, these patients may be refractory to the usual doses of epinephrine used to treat acute hypersensitivity reactions and may require a beta-agonist such as isoproterenol.
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.
Asthma
Major:
Timoptic Ocudose
The timolol ophthalmic in Timoptic Ocudose has a major potential interaction with Asthma.
Ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) in general should not be used in patients with a current or past history of bronchial asthma or chronic obstructive pulmonary disease. Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In the respiratory tract, beta blockade may adversely affect pulmonary function by counteracting the bronchodilation produced by catecholamine stimulation of beta-2 receptors. Although agents with beta-1 selectivity (e.g., betaxolol) are considered safer in patients with bronchospastic diseases, cardioselectivity is not absolute and may be lost with larger doses or higher plasma levels.
Bipolar Disorder
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.
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.
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.
Cardiogenic Shock
Major:
Timoptic Ocudose
The timolol ophthalmic in Timoptic Ocudose has a major potential interaction with Cardiogenic Shock.
The use of ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) is considered by manufacturers to be contraindicated in patients with cardiogenic shock. Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In cardiac tissues, beta blockade causes a reduction in inotropic as well as chronotropic activity, which may further depress cardiac output and blood pressure in such patients.
Cardiovascular Conditions and Disorders
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).
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.
Cerebral Vascular Disorder
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).
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.
Cerebrovascular Insufficiency
Major:
Timoptic Ocudose
The timolol ophthalmic in Timoptic Ocudose has a major potential interaction with Cerebrovascular Insufficiency.
Due to their negative inotropic and chronotropic effects on the heart, beta-adrenergic receptor blocking agents (aka beta-blockers) reduce cardiac output and may precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. In addition, the nonselective beta-blockers (e.g., timolol, carteolol) may attenuate catecholamine-mediated vasodilation during exercise by blocking beta-2 receptors in peripheral vessels. Since topically applied beta-blockers are systemically absorbed and may produce clinically significant systemic effects even at low or undetectable plasma levels, therapy with ophthalmic beta-blockers should be administered cautiously in patients with peripheral vascular disease. Close monitoring for progression of arterial obstruction is advised.
COPD
Major:
Timoptic Ocudose
The timolol ophthalmic in Timoptic Ocudose has a major potential interaction with COPD.
Ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) in general should not be used in patients with a current or past history of bronchial asthma or chronic obstructive pulmonary disease. Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In the respiratory tract, beta blockade may adversely affect pulmonary function by counteracting the bronchodilation produced by catecholamine stimulation of beta-2 receptors. Although agents with beta-1 selectivity (e.g., betaxolol) are considered safer in patients with bronchospastic diseases, cardioselectivity is not absolute and may be lost with larger doses or higher plasma levels.
Diabetes Mellitus
Major:
Timoptic Ocudose
The timolol ophthalmic in Timoptic Ocudose has a major potential interaction with Diabetes Mellitus.
Beta-adrenergic receptor blocking agents (aka beta-blockers) may mask symptoms of hypoglycemia such as tremors, tachycardia and blood pressure changes. In addition, the nonselective beta-blockers (e.g., timolol, carteolol) may inhibit catecholamine-mediated glycogenolysis, thereby potentiating insulin-induced hypoglycemia and delaying the recovery of normal blood glucose levels. Since topically applied beta-blockers are systemically absorbed and may produce clinically significant systemic effects even at low or undetectable plasma levels, therapy with ophthalmic beta-blockers should be administered cautiously in patients with diabetes or predisposed to spontaneous hypoglycemia.
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.
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.
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:
Timoptic Ocudose
The timolol ophthalmic in Timoptic Ocudose has a major potential interaction with Heart Block.
The use of ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) is considered by manufacturers to be contraindicated in patients with sinus bradyarrhythmia or heart block greater than the first degree (unless a functioning pacemaker is present). Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In cardiac tissues, beta blockade causes a reduction in inotropic as well as chronotropic activity, which may further depress cardiac function in such patients.
Heart Failure
Major:
Timoptic Ocudose
The timolol ophthalmic in Timoptic Ocudose has a major potential interaction with Heart Failure.
The use of ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) is considered by manufacturers to be contraindicated in patients with overt congestive heart failure (CHF). Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. Since sympathetic stimulation may be important in maintaining the hemodynamic function in patients with CHF, beta blockade can worsen the heart failure. However, therapy with ophthalmic beta-blockers can be administered cautiously in some CHF patients provided they are well compensated and receiving digitalis, diuretics, an ACE inhibitor, and/or nitrates. Beta-blockers should be discontinued if cardiac failure develops or worsens during therapy.
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.
Hyperthyroidism
Major:
Timoptic Ocudose
The timolol ophthalmic in Timoptic Ocudose has a major potential interaction with Hyperthyroidism.
Beta-adrenergic receptor blocking agents (aka beta-blockers) may mask some symptoms of hyperthyroidism such as tachycardia, anxiety, tremor, and heat intolerance. Abrupt withdrawal of beta-blocker therapy in thyrotoxic patients may exacerbate symptoms of hyperthyroidism or precipitate a thyroid storm. Since topically applied beta-blockers are systemically absorbed and may produce clinically significant systemic effects even at low or undetectable plasma levels, therapy with ophthalmic beta-blockers should be administered cautiously in patients with or suspected of having hyperthyroidism. Cessation of beta-blocker therapy, when necessary, should occur gradually over a period of 1 to 2 weeks. Patients should be advised not to discontinue treatment without first consulting with the physician. Close monitoring is recommended during and after therapy withdrawal.
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).
Hypotension
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.
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.
Myoneural Disorder
Moderate:
Timoptic Ocudose
The timolol ophthalmic in Timoptic Ocudose has a moderate potential interaction with Myoneural Disorder.
Topically applied beta-adrenergic receptor blocking agents (aka beta-blockers) are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In the nervous and musculoskeletal systems, beta blockade may potentiate muscle weakness consistent with certain myasthenic symptoms such as diplopia, ptosis, and generalized weakness. Several beta-blockers have been associated rarely with aggravation of muscle weakness in patients with preexisting myasthenia gravis or myasthenic symptoms.
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.
Peripheral Arterial Disease
Major:
Timoptic Ocudose
The timolol ophthalmic in Timoptic Ocudose has a major potential interaction with Peripheral Arterial Disease.
Due to their negative inotropic and chronotropic effects on the heart, beta-adrenergic receptor blocking agents (aka beta-blockers) reduce cardiac output and may precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. In addition, the nonselective beta-blockers (e.g., timolol, carteolol) may attenuate catecholamine-mediated vasodilation during exercise by blocking beta-2 receptors in peripheral vessels. Since topically applied beta-blockers are systemically absorbed and may produce clinically significant systemic effects even at low or undetectable plasma levels, therapy with ophthalmic beta-blockers should be administered cautiously in patients with peripheral vascular disease. Close monitoring for progression of arterial obstruction is advised.
Pheochromocytoma
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.
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.
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:
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.
Sinus Node Dysfunction
Major:
Timoptic Ocudose
The timolol ophthalmic in Timoptic Ocudose has a major potential interaction with Sinus Node Dysfunction.
The use of ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) is considered by manufacturers to be contraindicated in patients with sinus bradyarrhythmia or heart block greater than the first degree (unless a functioning pacemaker is present). Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In cardiac tissues, beta blockade causes a reduction in inotropic as well as chronotropic activity, which may further depress cardiac function in such patients.
More resources
Timoptic Ocudose
A total of 288 drugs are known to interact with Timoptic Ocudose.
- Timoptic ocudose is in the drug class ophthalmic glaucoma agents.
- Timoptic ocudose is used to treat the following conditions:
tranylcypromine
A total of 551 drugs are known to interact with tranylcypromine.
- Tranylcypromine is in the drug class monoamine oxidase inhibitors.
- Tranylcypromine is used to treat Depression.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.