Naltrexone and bupropion and Tranylcypromine interaction

Naltrexone and bupropion 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 Naltrexone and bupropion (Contrave Extended-Release) label · effective 2025-11-10

Major

…(e.g., buprenorphine) use, or acute opiate withdrawal [see Warnings and Precautions (5.4) and Drug Interactions (7.2) ] Patients undergoing an abrupt discontinuation of alcohol, benzodiazepines, barbiturates, and antiepileptic drugs [see Warnings and Precautions (5.3) and Drug Interactions (7.7) ] Concomitant administration of monoamine oxidase inhibitors (MAOI).

Contraindicationsby drug classView label on DailyMed
Major

At least 14 days should elapse between discontinuation of MAOI and initiation of treatment with CONTRAVE.

Contraindicationsby drug classView label on DailyMed
Major

There is an increased risk of hypertensive reactions when CONTRAVE is used concomitantly with MAOIs.

Contraindicationsby drug classView label on DailyMed
Major

Starting CONTRAVE in a patient treated with reversible MAOIs such as linezolid or intravenous methylene blue is also contraindicated [see Dosage and Administration (2.4) , Drug Interactions (7.1) ] Known allergy to bupropion, naltrexone or any other component of CONTRAVE.

Contraindicationsby drug classView label on DailyMed
Major

During or within 14 days of taking monoamine oxidase inhibitors (MAOI) ( 4 )

Contraindicationsby drug classView label on DailyMed

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

Major

…(MAOIs) selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) tricyclic antidepressants other antidepressants, such as amoxapine, bupropion, maprotiline, nefazodone, trazodone, vilazodone, vortioxetine amphetamines and methylphenidates medicines that can raise blood pressure (sympathomimetic medicine), such as…

Boxed warningnames Naltrexone and bupropionView label on DailyMed
Major

…(MAOIs) Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) Tricyclic antidepressants Other antidepressants (e.g., amoxapine, bupropion, maprotiline, nefazodone, trazodone, vilazodone, vortioxetine) Amphetamines and methylphenidates and derivatives Sympathomimetic products (e.g., cold, hay fever or weight…

Contraindicationsnames Naltrexone and bupropionView label on DailyMed
Major

…methylene blue, selective MAOIs) Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) Tricyclic antidepressants Amoxapine, bupropion, maprotiline, nefazodone, trazodone, vilazodone, vortioxetine Contraindicated a SS for all antidepressants For MAOIs, increased MAO inhibition and risk of adverse reactions,…

Drug interactionsnames Naltrexone and bupropionView label on DailyMed
Major

After stopping tranylcypromine sulfate tablets, at least 1 week should elapse before starting another MAOI (intended to treat MDD) or other contraindicated antidepressants.

Drug interactionsby drug classView label on DailyMed
Minor

Activation of Mania or Hypomania In patients with bipolar disorder, treating a depressive episode with tranylcypromine sulfate tablets or another antidepressant may precipitate a mixed/manic episode.

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.