Disulfiram and Tranylcypromine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Tranylcypromine
Disulfiram
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of delirium (agitation, disorientation, hallucinations)
Interaction Deep Dive
The combination of disulfiram with tranylcypromine has been reported to result in acute delirium in one patient, including symptoms such as agitation, disorientation, and hallucinations1. Further case reports or controlled studies are necessary to document the incidence and severity of adverse interactions between disulfiram and monoamine oxidase inhibitors such as tranylcypromine.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) A case report describes a possible interaction between tranylcypromine and disulfiram in a 48-year old man. The patient was receiving lithium 200 mg three times daily for three years for a bipolar mood disorder. He was also treated with disulfiram implants every ten months in order to prevent alcohol abuse. After suffering a depressive episode, moclobemide was given without effect. Moclobemide was then discontinued and tranylcypromine 10 mg twice daily was added. Two days later, the patient presented to the psychiatric emergency service with acute delirium. The patient was given haloperidol 5 mg and promethazine 50 mg. The patient was then transferred to the hospital, where he continued to suffer from agitation, disorientation, hallucinations, and nystagmus. The patient began to recover after several hours, and returned to normal over the next 24 hours. He had no recollection of the delirious episode. Although the mechanism of this drug interaction is not understood, the authors suggest that the combination of disulfiram and monoamine oxidase inhibitors should be avoided, even though the interacting agents may have been the two monoamine oxidase inhibitors 1.
Common questions
Can I take Disulfiram and Tranylcypromine together?
An increased risk of delirium (agitation, disorientation, hallucinations) Always confirm with your pharmacist or prescriber before making any change.
How serious is the Disulfiram and Tranylcypromine interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Disulfiram or Tranylcypromine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Blansjaar BA & Egberts TCG: Delirium in a patient treated with disulfiram and tranylcypromine. Am J Psychiatry 1995; 152:296. PubMed
Keep reading about Tranylcypromine
Keep reading about Disulfiram
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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