Phentermine and topiramate and Selegiline interaction

Phentermine and topiramate and Selegiline: 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 Phentermine and topiramate label · effective 2026-05-18

Major

…Warnings and Precautions (5.1) and Use in Specific Populations (8.1) ] With glaucoma [see Warnings and Precautions (5.3) ] With hyperthyroidism Taking or within 14 days of stopping a monoamine oxidase inhibitors [see Drug Interactions (7) ] With known hypersensitivity to phentermine, topiramate or any of the excipients in phentermine and topiramate extended-release…

Contraindicationsby drug classView label on DailyMed
Major

Taking or within 14 days of stopping monoamine oxidase inhibitors ( 4 )

Contraindicationsby drug classView label on DailyMed
Major

Intervention Concomitant use of phentermine and topiramate extended-release capsules are contraindicated during MAOI treatment and within 14 days of stopping an MAOI.

Drug interactionsby drug classView label on DailyMed
Moderate

Clinically Significant Drug Interactions with Phentermine and Topiramate Extended-Release Capsules Monoamine Oxidase Inhibitors Clinical Impact Concomitant use of phentermine with monoamine oxidase inhibitors (MAOIs) increases the risk of hypertensive crisis.

Drug interactionsby drug classView label on DailyMed

From the Selegiline (ZELAPAR) label · effective 2021-06-01

Moderate

Uncontrolled hypertension has been reported when taking the recommended dose of swallowed selegiline and a sympathomimetic medication (ephedrine).

Warnings and precautionsby drug classView label on DailyMed
Moderate

Sympathomimetic Medications Uncontrolled hypertension, including hypertensive crisis, has been reported when taking the recommended dose of swallowed selegiline and a sympathomimetic medication (ephedrine).

Drug interactionsby drug classView label on DailyMed
Moderate

Drugs that induce CYP3A4 (e.g., phenytoin, carbamazepine, nafcillin, phenobarbital, and rifampin) should be used with caution.

Drug interactionsby drug classView label on DailyMed
Minor

Drugs that Induce CYP450 Adequate studies have not been done investigating the effect of CYP3A4 inducers on selegiline.

Drug interactionsby 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.