Buprenorphine and Tranylcypromine interaction

Buprenorphine and Tranylcypromine: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Buprenorphine (BELBUCA) label · effective 2026-01-02

Major

Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: MAOI interactions with opioids may manifest as serotonin syndrome opioid toxicity (e.g., respiratory depression, coma) [see Warnings and Precautions (5.2) ].

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Major

Intervention: The use of BELBUCA is not recommended for patients taking MAOIs or within 14 days of stopping such treatment.

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Major

Serotonergic Drugs : Concomitant use may result in serotonin syndrome.

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Major

Avoid concomitant use in patients receiving MAOIs or within 14 days of stopping treatment with an MAOI.

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Moderate

Examples: phenelzine, tranylcypromine, linezolid Mixed Agonist/Antagonist and Partial Agonist Opioid Analgesics Clinical Impact: May reduce the analgesic effect of BELBUCA and/or precipitate withdrawal symptoms.

Drug interactionsnames TranylcypromineView label on DailyMed

From the Tranylcypromine (Tranylcypromine Sulfate) label · effective 2025-07-25

Moderate

Excessive reduction of blood glucose (additive effect) f CNS depressant agents (including opioids, alcohol, sedatives, hypnotics) Use with caution d Increased CNS depression Dietary supplements containing sympathomimetics Contraindicated a Antidepressants including but not limited to: Other MAOIs (e.g., linezolid, intravenous methylene blue, selective MAOIs)…

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.