Doxepin and Rasagiline interaction

Doxepin and Rasagiline: 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 Doxepin (Silenor) label · effective 2026-04-21

Major

Co-administration with Monoamine Oxidase Inhibitors (MAOIs): Do not administer if patient is taking MAOIs or has used MAOIs within the past two weeks.

Contraindicationsby drug classView label on DailyMed
Major

Co-administration with Monoamine Oxidase Inhibitors (MAOIs) Serious side effects and even death have been reported following the concomitant use of certain drugs with MAO inhibitors.

Contraindicationsby drug classView label on DailyMed
Major

Do not administer SILENOR if patient is currently on MAOIs or has used MAOIs within the past two weeks.

Contraindicationsby drug classView label on DailyMed
Major

The exact length of time may vary depending on the particular MAOI dosage and duration of treatment.

Contraindicationsby drug classView label on DailyMed
Major

DRUG INTERACTIONS MAO inhibitors: SILENOR should not be administered in patients on MAOIs within the past two weeks.

Drug interactionsby drug classView label on DailyMed

From the Rasagiline label · effective 2020-06-30

Major

May cause serotonin syndrome when used with antidepressants ( 5.2 )

Warnings and precautionsby drug classView label on DailyMed
Major

In the postmarketing period, potentially life-threatening serotonin syndrome has been reported in patients treated with antidepressants concomitantly with rasagiline.

Warnings and precautionsby drug classView label on DailyMed
Major

Concomitant use of rasagiline with one of many classes of antidepressants (e.g., SSRIs, SNRIs, triazolopyridine, tricyclic or tetracyclic antidepressants) is not recommended [see Drug Interactions ( 7.5 )].

Warnings and precautionsby drug classView label on DailyMed
Moderate

Although a small number of rasagiline-treated patients were concomitantly exposed to antidepressants (tricyclics n=115; SSRIs n=141), the exposure, both in dose and number of subjects, was not adequate to rule out the possibility of an untoward reaction from combining these agents.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Because of the long half-lives of certain antidepressants (e.g., fluoxetine and its active metabolite), at least five weeks (perhaps longer, especially if fluoxetine has been prescribed chronically and/or at higher doses) should elapse between discontinuation of fluoxetine and initiation of rasagiline [see Drug Interactions ( 7.5 )] .

Warnings and precautionsby drug classView label on DailyMed

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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.