PsychoTropical Research - Dr Ken Gillman, Serotonin Syndrome, Mirtazapine, Dual Action Drugs.MAOIs - Information, brief, for patients.

PsychoTropicalResearch, serotonin and serotonin syndrome research.

MAOIs - Information, brief, for patients

MAOIs - Information, brief, for patients

Date Created: 26/11/1999   Last Modified: 04/01/2003   Last Checked: 28/07/2004

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Advice and information concerning 'Aurorix' 'Manerix' 'Parnate' 'Nardil' 'Eldepryl' 'Selgene' (MAOIs)

This summary is intended to supplement other information given by your doctor and act as a reminder. Both you and your doctor may access more detailed information at www.psychotropical.com. Keep some means of identifying that you are on MAOIs on your person. Tell any medical practitioner or hospital that you take these drugs and show this advice.
This advice should be followed for a minimum of two weeks (as long as six weeks in some situations) after ceasing these drugs. In the case of 'Aurorix / Manerix' this need only be 1-3 days.

Foods to be avoided or restricted because of a 'tyramine' reaction (high BP).

  1. Cheeses, because some have very high levels of tyramine. 'Ricotta' and 'cottage' cheese types are always safe to eat.
  2. ‘Vegemite’, ‘Promite’, 'Marmite' (and similar brands) and most fermented soya bean products such as soya sauce, 'tofu' and 'miso'. Very small quantities only (discuss this with your doctor).
  3. Wine and spirits, only two drinks in any six hour period. Bottled beers are almost always safe providing they have no 'sediment'. Avoid ‘keg’ or 'tap' beer (discuss this with your doctor). No more than two alcoholic drinks in any six hour period.
  4. All meat products are safe if they are fresh. Particular care about freshness is advised with liver (including 'pate') which should be purchased fresh and eaten the same day. 'Salami' and 'pepperoni' sausages, and dried meats, are OK but only in small amounts.
  5. Sauerkraut and broad (fava) bean pods are best avoided but do not commonly contain high tyramine levels.

ND. 'Eldepryl' 'Selgene' does not usually require the above diet.

Interactions with other drugs

Cough and cold remedies available 'over the counter' must be double-checked. Avoid the anti-histamines brompheniramine or chlorpheniramine. Other anti-histamines are safe.

Analgesics (pain killers) that are safe to take with MAOIs:-- Aspirin and paracetamol and all the 'NSAIDs' (anti-inflammatory drugs used for arthritis) such as:-- brufen, ibuprofen, mefenamic acid, naproxen, indomethacin, phenylbutazone. All anti-anxiety drugs (benzodiazepines) like diazepam, oxazepam and temazepam are quite safe.

Stronger analgesics that are safe are:-- codeine, oxycodone and morphine. Some other strong analgesics are dangerous.

Dangerous analgesics

Pethidine, tramadol, dextromethorphan, dextropropoxyphene and pentazocine must be avoided.

Medical Treatment of high BP

If you think you have eaten something risky or have symptoms then see a doctor without delay and have your BP checked and monitored for a few hours by a doctor / hospital.

If the blood pressure is very high then drugs may be required to reduce it.

Make sure that any doctor who treats a reaction informs the prescribing doctor about it, preferably in writing.