Drug Interaction Report

CONTRAINDICATED: Tetrabenazine may cause excitation and hypertension in patients treated with monoamine oxidase inhibitors (MAOIs). The proposed mechanism has not been fully established but may be related to interference with biogenic amine storage. In addition, tetrabenazine may have depressant effects and may exacerbate depression. The same interaction can be expected for deutetrabenazine, a deuterium-containing analog of tetrabenazine.

MANAGEMENT: Concurrent administration of tetrabenazine and deutetrabenazine with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, linezolid, methylene blue, procarbazine) is considered contraindicated. At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with either tetrabenazine or deutetrabenazine, and vice versa.

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.