Monoamine oxidase inhibitors opioid analgesics

Monoamine oxidase inhibitors Relative contraindication to all opioid analgesics because of the high incidence of hyperpyrexic coma hypertension has also been reported. 

Drugs and chemicals are known to cause activated interaction. The depressant action of opioid drugs is enhanced by drugs acting on the central nervous system (CNS) such as alcohol, anesthetics, anxiolytics, hypnotics, tricyclic antidepressants, and antipsychotics. Concomitant administration of opioid analgesics and monoamine oxidase inhibitors (MAOIs) should be avoided, or extra care should be taken if such a therapy is inevitable. Fatal reactions are reported when treated along with selegiline. Interactions also are reported with cyclizine, cimetidine, mexiletine, cisapride, metoclopramide, or domperidone. 

Opioid analgesics interact with non-selective monoamine oxidase inhibitors, causing nervous system excitation and hypertension (70). These interactions have been reviewed (SEDA-18, 14). 

Concomitant use of some opioid analgesics, such as pethidine or dextropropoxyphene, with the selective monoamine oxidase inhibitors selegiline and moclobe-mide can enhance their nervous system toxicity (71). 

Monoamine oxidase inhibitors (MAOI) are not completely selective for MAO and impair the metabolism of tricyclic antidepressants, of some sympathomimetics, e.g. phenylpropanolamine, amfetamine, of opioid analgesics, especially pethidine, and of mercaptopurine. 

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