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Prudoxin Topical and Selegiline

Determining the interaction of Prudoxin Topical and Selegiline and the possibility of their joint administration.

Check result:

Prudoxin Topical <> Selegiline

Relevance: 28.10.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

The medication in doxepin topical is absorbed through the skin into the bloodstream and may cause interactions with other medications such as selegiline. When used together, this combination may produce a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. In general, you should wait at least 14 days after stopping selegiline before you start treatment with doxepin topical, and vice versa. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: Topically administered doxepin may be systemically absorbed and produce plasma levels that approach therapeutic ranges. While drug interaction studies have not been conducted with topical doxepin, coadministration of oral tricyclic antidepressants with monoamine oxidase inhibitors (MAOIs) has been associated with significant adverse reactions including nausea, vomiting, flushing, dizziness, tremor, myoclonus, rigidity, diaphoresis, hyperthermia, autonomic instability, hypertensive crisis, disseminated intravascular coagulation, severe convulsive seizures, coma, and death. The exact mechanism is unknown but may be related to excessive serotonergic activity in the CNS (i.e., serotonin syndrome).

MANAGEMENT: As with oral doxepin and other tricyclic antidepressants, topical doxepin should not be used concurrently with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, methylene blue, procarbazine). At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with topical doxepin, and vice versa.

References

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Lader M "Combined use of tricyclic antidepressants and monoamine oxidase inhibitors." J Clin Psychiatry 44 (1983): 20-4
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Goldberg LI "Monoamine oxidase inhibitors: adverse reactions and possible mechanisms." JAMA 190 (1964): 456-62
Pettinger WA, Soyangco FG, Oates JA "Inhibition of monoamine oxidase in man by furazolidone." Clin Pharmacol Ther 9 (1968): 442-7
Mills KC "Serotonin syndrome: A clinical update." Crit Care Clin 13 (1997): 763
Sternbach H "The serotonin syndrome." Am J Psychiatry 148 (1991): 705-13
Schulz R, Antonin KH, Hoffmann E, et al "Tyramine kinetics and pressor sensitivity during monoamine oxidase inhibition by selegiline." Clin Pharmacol Ther 46 (1989): 528-36
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Kline SS, Mauro LS, Scala-Bennett DM, Zick D "Serotonin syndrome versus neuroleptic malignant death syndrome as a cause of death." Clin Pharm 8 (1989): 510-4
Insel TR, Roy BF, Cohen RM, Murphy DL "Possible development of the serotonin syndrome in man." Am J Psychiatry 139 (1982): 954-5
Tackley RM, Tregaskis B "Fatal disseminated intravascular coagulation following a monoamine oxidase inhibitor/tricyclic interaction." Anaesthesia 42 (1987): 760-3
"Product Information. Zonalon (doxepin topical)." Bioglan Pharmaceutical Inc, Malvern, PA.
White K, Simpson G "Combined MAOI-tricyclic antidepressant treatment: a reevaluation." J Clin Psychopharmacol 1 (1981): 264-82
De Vita VT, Hahn MA, Oliverio VT "Monoamine oxidase inhibition by a new carcinostatic agent, n-isopropyl-a-(2-methylhydrazino)-p-toluamide (MIH). (30590)." Proc Soc Exp Biol Med 120 (1965): 561-5
Nierenberg DW, Semprebon M "The central nervous system serotonin syndrome." Clin Pharmacol Ther 53 (1993): 84-8

Prudoxin Topical

Generic Name: doxepin topical

Brand name: Prudoxin, Zonalon

Synonyms: Prudoxin (Topical), Prudoxin

What is Prudoxin Topical?

Selegiline

Generic Name: selegiline

Brand name: Eldepryl, Zelapar, Emsam

Synonyms: n.a.

What is Selegiline?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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