Critical
Almotriptan × Phenelzine
Selective serotonin 5HT1B/1D agonists (triptans)×Antidepressant, irreversible non-selective monoamine oxidase inhibitor (MAO-A and MAO-B)
Mechanism
Almotriptan is CYP3A4 + CYP2D6 substrate. With phenelzine – fatal serotonin syndrome.
Symptoms
Agitation, tachycardia, hyperthermia, myoclonus, hyperreflexia within hours.
Management
Combination contraindicated. 14 days after MAOI withdrawal before starting triptan.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.