MAOIS INHIBIT THE METABOLISM OF SYMPATHOMIMETICS WHICH CAN LEAD TO DANGEROUS ENHANCEMENT OF THEIR PRESSOR EFFECTS. USE WITH BUSPIRONERISES BLOOD PRESSURE. INHIBITION OF DRUG-METABOLISING ENZYMES BY MAOIS MAY ENHANCE THE EFFECTS OF BARBITURATES, HYPNOTICS, HYPOGLYCAEMICS AND ANTIMUSCARINICS. CONCURRENT ADMINISTRATION OF MAOIS AND OPIOID ANALGESICS IS ASSOCIATED WITH SEVERE AND SOMETIMES FATAL REACTIONS. THE HYPOTENSIVE EFFECTS OF BETABLOCKERS AND THIAZIDE DIURETICS MAY BE ENHANCED. CLOZAPINE MAY ENHANCE THE CNS EFFECTS OF MAOIS. IT SHOULD NOT GENERALLY BE GIVEN TO PATIENTS RECEIVING TRICYCLIC ANTIDEPRESSANTS, SELECTIVE SEROTONIN REUPTAKE INHIBITORS, SEROTONIN AND NORADRENALINE REUPTAKE INHIBITORS, OR NEFAZODONE OR TRAZODONE. WITH ALCOHOL THERE IS POSSIBILITY OF EXCITATION, SEIZURES, DELIRIUM, HYPERPYREXIA, CIRCULATORY COLLAPSE, COMA & DEATH. ANESTHETICS (GENERAL) -: HYPOTENSIVE EFFECT; USE TOGETHER WITH CAUTION. ANTIDEPRESSANTS (TRICYCLIC) :- CONCOMITANT USE MAY CAUSE EXCITATION, SWEATING, TACHYCARDIA, TACHYPNEA, HYPERPYREXIA, DISSEMINATED INTRAVASCULAR COAGULATION, DELIRIUM, TREMORS, CONVULSIONS, DEATH. ANTIHYPERTENSIVE DRUGS :- EXAGGERATED HYPOTENSIVE EFFECTS. BETA-ADRENERGIC BLOCKING DRUGS :- EXAGGERATED HYPOTENSIVE EFFECTS. BUSPIRONE:- ELEVATED BP. DEXTROMETHORPHAN:- BRIEF EPISODES OF PSYCHOSIS OR BIZARRE BEHAVIOR. EPHEDRA :- SEE SYMPATHOMIMETIC DRUGS BELOW. FLUOXETINE :- POSSIBILITY OF HYPERTHERMIA, RIGIDITY, MYOCLONIC MOVEMENTS, DEATH. GINSENG :- RISK OF HEADACHE, MANIA, OR TREMORS. MAO INHIBITORS :- CONCOMITANT USE OF TRANYLCYPROMINE WITH OTHER MAO INHIBITORS MAY CAUSE A HYPERTENSIVE CRISIS OR SEVERE SEIZURES. DISCONTINUE THE MAO INHIBITOR AT LEAST 7-10 DAYS BEFORE INITIATING A NEW DRUG. HOWEVER, SUCH COMBINATIONS HAVE BEEN USED TOGETHER SUCCESSFULLY. MEPERIDINE:- SEE NARCOTICS. NARCOTICS:- POSSIBILITY OF EXCITATION, SEIZURES, DELIRIUM, HYPERPYREXIA, CIRCULATORY COLLAPSE, COMA, DEATH. ST. JOHN'S WORT :- DO NOT USE WITH TRANYLCYPROMINE. SCOTCH BROOM HERB:- RISK OF HYPERTENSIVE CRISIS. SELECTIVE SEROTONIN REUPTAKE INHIBITORS:- SEE FLUOXETINE. SYMPATHOMIMETIC DRUGS--AMPHETAMINE, COCAINE, DOPA, EPHEDRINE, EPINEPHRINE, METARAMINOL, METHYLDOPA, METHYLPHENIDATE, NOREPINEPHRINE, PHENYLEPHRINE, PHENYLPROPANOLAMINE. MANY OTC COLD PRODUCTS, HAY FEVER MEDICATIONS, AND NASAL DECONGESTANTS CONTAIN ONE OR MORE OF THESE SYMPATHOMIMETIC DRUGS. ALL PERIPHERAL, METABOLIC, CARDIAC, AND CENTRAL EFFECTS ARE POTENTIATED FOR UP TO 2 WEEKS AFTER TERMINATION OF MAO INHIBITOR THERAPY. SYMPTOMS INCLUDE ACUTE HYPERTENSIVE CRISIS WITH POSSIBLE INTRACRANIAL HEMORRHAGE, HYPERTHERMIA, COMA, AND POSSIBLY DEATH. THIAZIDE DIURETICS:- EXAGGERATED HYPOTENSIVE EFFECTS. TRYPTOPHAN :- POSSIBILITY OF BEHAVIORAL AND NEUROLOGIC EFFECTS, INCLUDING DISORIENTATION, CONFUSION, AMNESIA, DELIRIUM, AGITATION, HYPOMANIA, ATAXIA, MYOCLONUS, HYPERREFLEXIA, SHIVERING, OCULAR OSCILLATION,AND BABINSKI SIGNS. TYRAMINE-RICH FOODS-- (BEER, BROAD BEANS, CERTAIN CHEESES (BRIE, CHEDDAR, CAMEMBERT, STILTON), CHIANTI WINE, CHICKEN LIVERS, CAFFEINE, COLA BEVERAGES, FIGS, LICORICE, LIVER, PICKLED OR KIPPERED HERRING DRY SAUSAGE (GENOA SALAMI, HARD SALAMI, PEPPERONI, LEBANON BOLOGNA), TEA, CREAM, YOGURT, YEAST EXTRACT, AND CHOCOLATE ) CAN CAUSE HYPERTENSIVE CRISIS, INCLUDING SEVERE HEADACHE, HYPERTENSION, INTRACRANIAL HEMORRHAGE, DEATH.