Drug General Information (ID: DDILJ83MHE)
Drug Name			Tranylcypromine		Drug Info		Opium		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antidepressants				Narcotic Analgesics

Mechanism of Tranylcypromine-Opium Interaction (Severity Level: Major)
Additive CNS depression effects Click to Show/Hide Mechanism Graph
Drug Name		Tranylcypromine				Opium
Mechanism		CNS depression effects				CNS depression effects
Key Mechanism Factor 1
		Factor Name		CNS depression effects
		Factor Description		CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
Mechanism Description		Additive CNS depression effects by the combination of Tranylcypromine and Opium

Recommended Action
Management		Narcotic analgesics should generally not be used with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, linezolid, methylene blue, procarbazine). At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with opioids. However, morphine has been safely used in MAOI-treated patients who previously had an adverse reaction with meperidine and is generally suggested as an alternative to meperidine in anesthesia. A sensitivity test should be performed in which repeated, small, incremental doses of morphine are administered over the course of several hours while overall clinical status and vital signs are carefully monitored.

References
1	Product Information. Emsam (selegiline). Bristol-Myers Squibb, Princeton, NJ.
2	Product Information. MS Contin (morphine). Purdue Frederick Company, Norwalk, CT.
3	Product Information. Nubain (nalbuphine). Endo Laboratories, Texarkana, TX.