Tapentadol and Tranylcypromine interaction

Tapentadol 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 Tapentadol label · effective 2026-02-26

Major

…suspected paralytic ileus [see Warnings and Precautions (5.12) ] Hypersensitivity to tapentadol (e.g., anaphylaxis, angioedema) or to any other ingredients of the product [see Adverse Reactions (6.2) ] Concurrent use of monoamine oxidase inhibitors (MAOIs) or use of MAOIs within the last 14 days [see Drug Interactions (7) ] Significant respiratory depression ( 4 )

Contraindicationsby drug classView label on DailyMed
Major

Concurrent use of monoamine oxidase inhibitors (MAOIs) or use of MAOIs within the last 14 days.

Contraindicationsby drug classView label on DailyMed
Major

Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (e.g., respiratory depression, coma) [see Warnings and Precautions (5.3) ] Intervention: Do not use tapentadol tablets in patients taking MAOIs or within 14 days of stopping such treatment.

Drug interactionsby drug classView label on DailyMed
Moderate

Examples: phenelzine, tranylcypromine, linezolid Mixed Agonist/Antagonist and Partial Agonist Opioid Analgesics Clinical Impact: May reduce the analgesic effect of tapentadol tablets and/or precipitate withdrawal symptoms.

Drug interactionsnames TranylcypromineView label on DailyMed
Minor

…neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e., cyclobenzaprine, metaxalone), and drugs that impair metabolism of serotonin (including monoamine oxidase inhibitors, both those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue) [see Drug Interactions (7) ] .

Warnings and precautionsby drug classView label on DailyMed

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

Major

…triptans buspirone carbamazepine dextromethorphan dopamine hydroxytryptophan and tryptophan levodopa and methyldopa meperidine rasagline resperine s-adenosyl-L-methionine (SAM-e) tapentadol tetrabenazin Ask your healthcare provider or pharmacist if you are not sure if you take any of these medicines. have a tumor on your adrenal gland called a pheochromocytoma…

Boxed warningnames TapentadolView label on DailyMed
Major

…supplements that contain sympathomimetics) Triptans Individual Drugs (not included in the above classes) buspirone levodopa s-adenosyl-L-methionine (SAM-e) carbamazepine meperidine tapentadol cyclobenzaprine methyldopa tetrabenazine dextromethorphan milnacipran tryptophan dopamine rasagiline hydroxytryptophan reserpine 4.2 Pheochromocytoma and Catecholamine-Releasing…

Contraindicationsnames TapentadolView label on DailyMed
Major

Serotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with MAOIs when used concomitantly with other serotonergic drugs.

Warnings and precautionsby drug classView label on DailyMed
Major

The concomitant use, or use in rapid succession, of tranylcypromine sulfate tablets with other serotonergic drugs is contraindicated.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Excessive reduction of blood glucose (additive effect) f CNS depressant agents (including opioids, alcohol, sedatives, hypnotics) Use with caution d Increased CNS depression Dietary supplements containing sympathomimetics Contraindicated a Antidepressants including but not limited to: Other MAOIs (e.g., linezolid, intravenous methylene blue, selective MAOIs)…

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.