Aurorix Drug Interactions

Co-administration of moclobemide with selegiline or with lenezolid is contraindicated.
Co-administration of moclobemide with triptans is contraindicated because they are potent serotonin receptor agonists and metabolized by monoamine oxidases (MAOs) and various cytochrome P450 enzymes thus increasing the plasma concentrations of the triptans (such as sumatriptan, rizatriptan, zolmitriptan, almotriptan, naratriptan, frovatriptan and eletriptan).
Co-administration of moclobemide with tramadol is contraindicated.
In animals, moclobemide potentiates the effects of opiates. Concomitant use of moclobemide and opioids/opiate products (e.g., buprenorphine, buprenorphine containing products) may result in serotonin syndrome, a potentially life-threatening condition (see General under Precautions). A dosage adjustment of the following products (e.g. morphine, fentanyl and codeine) may become necessary.
The combination with pethidine is contra-indicated because of the increased risk of serotonergic syndrome (confusion, fever, convulsions, ataxia, hyperreflexia, myoclonus, diarrhoea).
In pharmacological studies, moclobemide has shown minor potential only in respect of interactions with tyramine (see General under Precautions). The potentiation of the pressor effect was even lower or did not occur when moclobemide was administered after a meal.
In order to obtain normal plasma levels, the daily dose of moclobemide should be reduced to half or one-third in patients who concomitantly use a medicinal product that inhibits the activity of certain liver enzymes (microsomal mono-oxidase), such as cimetidine (see Special Dosage Instructions under Dosage & Administration).
Care should be taken with concomitant use of medicinal products that are metabolised by CYP2C19 as moclobemide is an inhibitor of this enzyme. The plasma concentration of these drugs (such as proton pump inhibitors (e.g. omeprazole), fluoxetine and fluvoxamine) may be increased when concomitantly used with moclobemide.
Care should be taken with concomitant use of trimipramine and maprotiline as the plasma concentration of these monoamine reuptake inhibitors increases upon concomitant administration with moclobemide.
The pharmacologic action of systemic regimens of sympathomimetic agents may possibly be intensified and prolonged by concurrent treatment with moclobemide (e.g adrenergics).
In patients receiving moclobemide, additional drugs that enhance serotonin, such as many other antidepressants, particularly in multiple-drug combinations, should be given with caution. This applies in particular to anti-depressants such as venlafaxine, fluvoxamine, clomipramine, citalopram, escitalopram, paroxetine, sertraline, bupropion. In isolated cases, serious symptoms and signs, including hyperthermia, confusion, hyperreflexia and myoclonus, were reported which are indicative of serotonergic overactivity. Should such combined symptoms occur, the patient should be closely observed by a physician (and if necessary hospitalized) and appropriate treatment given.
Treatment with tricyclic or other antidepressant agents could be initiated the next day after withdrawal of moclobemide. When switching from other antidepressants to moclobemide, a washout phase is recommended the duration of which depends on the half-life of the previously administered antidepressants (see Special Dosage Instructions under Dosage & Administration).
Concomitant use with St. John’s wort (Hypericum) products is not recommended as this may increase the serotonin serum concentration in the central nervous system.
Moclobemide must not be co-administered with dextromethorphan (may be contained in medicines used to treat colds, for instance) (see Precautions).
Data from clinical studies suggests that no interactions exist between moclobemide and hydrochlorothiazide (HCT), in hypertensive patients, with oral contraceptives, digoxin, phenprocoumon, and alcohol.
As sibutramine is a nor-epinephrine-serotonin reuptake inhibitor, which would increase the effect of MAOIs, the concomitant use with moclobemide is not recommended.
Concomitant use of dextropropoxyphene is not advised as moclobemide may potentiate the effects of dextropropoxyphene.