MAJOR — Use With Caution
Tianeptine and MAOIs — ABSOLUTELY CONTRAINDICATED (Serotonin Syndrome/Hypertensive Crisis)
Evidence level: STRONG
LIFE-THREATENING COMBINATION. Tianeptine and MAO inhibitors can trigger serotonin syndrome — a potentially fatal condition causing dangerously high body temperature, seizures, and organ failure. This combination is absolutely contraindicated.
Tianeptine combined with MAO inhibitors risks severe serotonin syndrome and hypertensive crisis. Tianeptine modulates serotonin reuptake and has opioid activity; MAOIs prevent monoamine breakdown. The combination can produce dangerous accumulation of serotonin and norepinephrine. This is an absolute contraindication per tianeptine prescribing information in countries where it is approved.
NEVER take tianeptine with any MAOI. A minimum 14-day washout is required between stopping an MAOI and starting tianeptine (or vice versa). If you experience high fever, rigid muscles, rapid heartbeat, or agitation, seek emergency care immediately.
Take Selegiline as prescribed. Tianeptine can typically be taken with a meal, spaced 1-2 hours from the medication for clean absorption. Discuss this combination with your pharmacist for personalized guidance.
Higher risk for: elderly, those with liver or kidney impairment, polypharmacy (5+ medications), recent medication changes, or those with multiple chronic conditions. Consult your pharmacist for specific risk factors.
High fever (>104F), severe muscle rigidity, rapid heart rate, blood pressure spikes, agitation, confusion, seizures, profuse sweating, diarrhea. This is a medical emergency — call 911.
This combination is absolutely contraindicated. Discuss safe antidepressant alternatives. Ensure adequate washout period between agents. Monitor for serotonin syndrome symptoms during any transition.
Discuss safer alternatives with your healthcare provider. They can recommend substitutions based on your specific health goals while minimizing interaction risks. Always bring a complete list of everything you take to your appointments.
LIFE-THREATENING COMBINATION. Tianeptine and MAO inhibitors can trigger serotonin syndrome — a potentially fatal condition causing dangerously high body temperature, seizures, and organ failure. This combination is absolutely contraindicated.
Take Selegiline as prescribed. Tianeptine can typically be taken with a meal, spaced 1-2 hours from the medication for clean absorption. Discuss this combination with your pharmacist for personalized guidance.
High fever (>104F), severe muscle rigidity, rapid heart rate, blood pressure spikes, agitation, confusion, seizures, profuse sweating, diarrhea. This is a medical emergency — call 911.
Discuss safer alternatives with your healthcare provider. They can recommend substitutions based on your specific health goals while minimizing interaction risks. Always bring a complete list of everything you take to your appointments.
This combination is absolutely contraindicated. Discuss safe antidepressant alternatives. Ensure adequate washout period between agents. Monitor for serotonin syndrome symptoms during any transition.
Or browse the full interaction database (121,000+ pairs).