Tramadol Phenelzine

Clinically important, potentially hazardous interactions with dexibuprofen, isocarboxazid, MAO inhibitors, phenelzine, selegiline, St John s wort, sumatriptan, tramadol, tranylcypromine, trazodone... 

Clinically important, potentially hazardous interactions with alprazolam, amphetamines, astemizole, clarithromycin, clozapine, desipramine, dexibuprofen, dextroamphetamine, diethylpropion, droperidol, duloxetine, erythromycin, haloperidol, imipramine, isocarboxazid, linezolid, lithium, MAO inhibitors, mazindol, meperidine, methamphetamine, midazolam, moclobemide, nortriptyline, phendimetrazine, phenelzine, phentermine, phenylpropanolamine, phenytoin, pimozide, pseudoephedrine, selegiline, serotonin agonists, sibutramine, St John s wort, sumatriptan, sympathomimetics, tramadol, tranylcypromine, trazodone, tricyclic antidepressants, troleandomycin, tryptophan, zolmitriptan... 

The serotonin syndrome developed in one patient on iproniazid and tramadol, and delirium in another given tramadol shortly after stopping phenelzine. A fatal case of possible serotonin syndrome has been seen with tramadol, moclobemide and clomipramine. 

Know the mechanism of action of your muscle relaxant. If the patient is already taking tramadol or tapentadol as well as amitriptyline, consider your rationale for adding a third agent with serotonergic activity such as cyclobenzaprine, as well as the increased risk of serotonin syndrome. Do not use cyclobenzaprine within 2 weeks of the last dose of an MAOI. Some MAOIs include isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), selegiline (Eldepryl, Emsam),... 

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