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Interacting Drugs

OBJECT DRUGS

MAO Inhibitors (nonselective):

MAO-B Inhibitors:

PRECIPITANT DRUGS

Serotonergic Drugs:

* Propoxyphene (Darvon) was withdrawn from the US market.


Comment:

Linezolid appears to be a weak MAOI, but serotonin syndrome has been reported when it is combined with serotonergic agents, including SSRIs and SNRIs. Selective MAO-B inhibitors theoretically should not interact with serotonergic drugs, and many patients have received these combinations safely. For example, one study found no interaction when rasagiline and citalopram were given together. Some patients on MAO-B inhibitors, however, may develop nonselective MAO inhibition. Rasagiline is metabolized by CYP1A2, so theoretically, patients on CYP1A2 inhibitors may be more likely to develop nonselective MAO inhibition due to rasagiline. (For a list of CYP1A2 inhibitors, see CYP 450 Table at front of book.) (Note: Concurrent use of 2 or more serotonergic drugs (from the 2 right columns above) may increase the risk of serotonin syndrome, but only isolated cases have been reported.)


Class 2: Use only if Benefit Felt to Outweigh Risk