Triptans Monoamine oxidase inhibitors

The triptans should be used with caution in patients on lithium, monoamine oxidase inhibitors or selective serotonin reuptake inhibitors, due to the rare occurrence of the serotonin syndrome. 

Some of the triptans are metabolized by monoamine oxidase and they should not be used with monoamine oxidase inhibitors. This includes almotriptan (34), rizatriptan (35), sumatriptan (36), and zolmitriptan (28). The effect of moclobemide on the pharmacokinetics of almotriptan was less than with other triptans (34). 

The triptans are contraindicated in patients who have a history of ischemic or vasospastic CAD, cerebrovascular or peripheral vascular disease, or other significant cardiovascular diseases. Because triptans may cause an acute, usually small, increase in blood pressure (BP), they also are contraindicated in patients with uncontrolled hypertension. Naratriptan is contraindicated in patients with severe renal or hepatic impairment. Rizatriptan should be used with caution in patients with renal or hepatic disease but is not contraindicated in such patients. Sumatriptan, rizatriptan, and zolmitriptan are contraindicated in patients who are taking monoamine oxidase inhibitors. 

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