Protriptyline and Selegiline interaction

Protriptyline 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 Selegiline (ZELAPAR) label · effective 2021-06-01

Major

John’s wort or cyclobenzaprine (a tricyclic muscle relaxant).

Contraindicationsby drug classView label on DailyMed
Major

• May cause serotonin syndrome when used with antidepressants (5.2)

Warnings and precautionsby drug classView label on DailyMed
Major

In the post-marketing period, fatal and non-fatal cases of serotonin syndrome have been reported in patients treated with antidepressants concomitantly with ZELAPAR [see Contraindications (4) and Drug Interactions ( 7.1 , 7.2 , 7.3 )] .

Warnings and precautionsby drug classView label on DailyMed
Major

Because the mechanisms responsible for these reactions are not fully understood, avoid the combination of ZELAPAR with any antidepressant.

Warnings and precautionsby drug classView label on DailyMed
Moderate

…allow concomitant use of any selective serotonin re-uptake inhibitor (e.g., fluoxetine-Prozac, fluvoxamine-Luvox, paroxetine-Paxil, sertraline, venlafaxine-Effexor, or nefazodone-Serzone) or any non-selective serotonin reuptake inhibiting antidepressant drug (except when taken at a low dose and only at night for the purpose of effective sleep) with ZELAPAR.

Warnings and precautionsby drug classView label on DailyMed

From the Protriptyline (Protriptyline Hydrochloride) label · effective 2023-07-25

Major

When it is desired to substitute protriptyline for a monoamine oxidase inhibitor, a minimum of 14 days should be allowed to elapse after the latter is discontinued.

Contraindicationsby 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.