Drug Interactions

Contraindications for co-administration (Do not co-administer with the following.)

Drugs Signs, symptoms, and Treatment Mechanism and
Risk factors
MAO inhibitors
Selegiline hydrochloride
Rasagiline mesilate
Serious adverse reactions including
hypertensive crisis and serotonin syndrome may occur. At least 14 days should elapse between discontinuation of this drug and initiation of the drugs in the left column. In addition, at least 14 days should elapse between discontinuation of the drugs in the left column and initiation of this drug.
The effect of this drug to inhibit MAO-B may induce an additive
effect.
Pethidine hydrochloride-containing products

Tramadol hydrochloride-containing
Products

Tapentadol hydrochloride

Serious adverse reactions including serotonin
syndrome may occur. At least 14 days should elapse between discontinuation of this drug and initiation of the drugs in the left column. In addition, at least 2 to 3 days should elapse between discontinuation of tramadol hydrochloride-containing products and initiation of this drug.
The mechanism is not known.
Tricyclic antidepressants
Amitriptyline hydrochloride
Amoxapine
Imipramine hydrochloride
Clomipramine hydrochloride
Dosulepin hydrochloride
Trimipramine maleate
Nortriptyline hydrochloride
Lofepramine hydrochloride
Co-administration with other MAO-B inhibitors was associated with adverse reactions including hypertension, syncope, asystole, sweating, epilepsy, altered motor/mental disorder, and rigidity, and the reports of death.
At least 14 days should elapse between discontinuation of this drug and initiation of
the drugs in the left column. In addition, at least 2 to 3 days should elapse between discontinuation of the drugs in the left column and initiation of this drug.
Additive or synergistic effects may occur, although the
mechanism is not known.
Tetracyclic antidepressants
Maprotiline hydrochloride
Mianserin hydrochloride
Setiptiline maleate
Selective serotonin reuptake inhibitors
Fluvoxamine maleate
Paroxetine hydrochloride hydrate
Sertraline hydrochloride
Escitalopram oxalate
Serious adverse reactions including serotonin syndrome may occur. At least 14 days should elapse between discontinuation of this drug and initiation of the drugs in the left column. In addition, between discontinuation of the drugs in the left column and initiation of this drug, at least 7 days should elapse for fluvoxamine maleate, and at least 14 days should elapse for paroxetine hydrochloride hydrate, sertraline hydrochloride, and escitalopram oxalate. The effect of these drugs to inhibit serotonin reuptake may increase brain serotonin concentration.
Serotonin–noradrenaline reuptake
inhibitors
Milnacipran hydrochloride
Duloxetine hydrochloride
Venlafaxine hydrochloride
Serious adverse reactions including serotonin syndrome may occur. At least 14 days should elapse between discontinuation of this drug and initiation of the drugs in the left column. In addition, between discontinuation of the drugs in the left column and initiation of this drug, at
least 2 to 3 days should elapse for milnacipran hydrochloride, at least 5 days should elapse for duloxetine hydrochloride, and at least 7 days
should elapse for venlafaxine hydrochloride.
The degradation of monoamine
neurotransmitters may be suppressed, and the total amount
of monoamine in the brain may increase.
Selective noradrenaline reuptake inhibitors
Atomoxetine hydrochloride
Serious adverse reactions including serotonin syndrome may occur. At least 14 days should
elapse between discontinuation of this drug and initiation of the drugs in the left column. In addition, at least 14 days should elapse between discontinuation of the drugs in the left column and initiation of this drug.
Noradrenergic and serotonergic
antidepressant
Mirtazapine
Serious adverse reactions including serotonin syndrome may occur. At least 14 days should
elapse between discontinuation of this drug and initiation of the drugs in the left column.
In addition, at least 14 days should elapse between discontinuation of the drugs in the left column and initiation of this drug.
The neurotransmission of noradrenaline and serotonin in the brain may be enhanced, and the total amount of monoamine in the brain may increase.
Central nervous system stimulants
Methylphenidate hydrochloride
Lisdexamfetamine mesilate
Serious adverse reactions including
hypertensive crisis may occur. At least 14
days should elapse between discontinuation of
this drug and initiation of the drugs in the left
column.
The total amount of monoamine in the brain may increase.

 

Precautions for Co-administration (This drug should be administered with caution when co-administered with the following.)

Drugs Signs, symptoms, and Treatment Mechanism and
Risk factors
Trazodone hydrochloride Administration of this drug immediately after discontinuation of trazodone hydrochloride or concomitantly with trazodone hydrochloride may increase brain serotonin concentration. The effect of this drug to inhibit serotonin reuptake may increase brain serotonin concentration.
Reserpine derivative
Reserpine
The effect of this drug may be reduced. Brain dopamine is reduced.
Phenothiazines
Chlorpromazine
Butyrophenones
Haloperidol
Sulpiride
Metoclopramide
The dopamine receptors in the brain are blocked.
Dextromethorphan hydrobromide hydrate Serotonin syndrome may occur. The effect of dextromethorphan hydrobromide hydrate to increase brain
serotonin concentration may further increase brain serotonin concentration
Linezolid Increased blood pressure, etc. including
hypertensive crisis may occur.
Coadministration with linezolid, which has a nonselective, reversible MAO inhibitory effect, may induce an additive effect.
Sympathomimetic agents:
Ephedrine hydrochloride
Methylephedrine hydrochloride
Pseudoephedrine hydrochloride-containing drugs
Phenylpropanolamine-containing
drugs
Increased blood pressure including
hypertensive crisis may occur.
The sympathomimetic effect of these drugs may be enhanced if the selectivity for MAO-B is lowered.