Selegiline and Venlafaxine interaction
Selegiline and Venlafaxine: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
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
• May cause serotonin syndrome when used with antidepressants (5.2)
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 )] .
Because the mechanisms responsible for these reactions are not fully understood, avoid the combination of ZELAPAR with any antidepressant.
…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.
In patients taking antidepressants with a long half-life (e.g., fluoxetine and its active metabolite), allow at least five weeks (perhaps longer, especially if fluoxetine has been prescribed chronically and/or at higher doses) to elapse between discontinuation of fluoxetine and initiation of ZELAPAR [see Drug Interactions (7.6) ] .
From the Venlafaxine (Venlafaxine Hydrochloride) label · effective 2025-01-31
Serotonin Syndrome and MAOIs: Do not use MAOI’s intended to treat psychiatric disorders with Venlafaxine Extended Release Tablets or within 7 days of stopping treatment with Venlafaxine Extended Release Tablets.
Do not use Venlafaxine Extended Release Tablets within 14 days of stopping an MAOI intended to treat psychiatric disorders.
Monoamine Oxidase Inhibitors (MAOIs) The use of MAOI’s intended to treat psychiatric disorders with Venlafaxine Extended Release Tablets or within 7 days of stopping treatment with Venlafaxine Extended Release Tablets is contraindicated because of an increased risk of serotonin syndrome.
The use of Venlafaxine Extended Release Tablets within 14 days of stopping, an MAOI intended to treat psychiatric disorders is also contraindicated [see Dosage and Administration ( 2.6 ), and Warnings and Precautions ( 5.2 )] .
Starting Venlafaxine Extended Release Tablets in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome [see Dosage and Administration ( 2.7 ) and Warnings and Precautions ( 5.2 )] .
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot 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.