Critical
Sumatriptan × Tranylcypromine
Selective 5-HT1B/1D serotonin receptor agonist×Antidepressant, irreversible non-selective monoamine oxidase inhibitor (MAO-A and MAO-B), amphetamine derivative
Mechanism
Tranylcypromine irreversibly inhibits MAO-A. Sumatriptan accumulates – 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.