Critical
Phenelzine × Zolmitriptan
Antidepressant, irreversible non-selective monoamine oxidase inhibitor (MAO-A and MAO-B)×Triptan, selective 5HT1B/1D receptor agonist
Mechanism
Zolmitriptan is MAO-A + CYP1A2 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.