Isocarboxazid and Albuterol Oral Inhalation: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Isocarboxazid
Albuterol Oral Inhalation
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.
Isocarboxazid (Marplan) is a type of antidepressant called an MAO inhibitor. Albuterol is a rescue inhaler that opens up your airways, but it also gently stimulates the same body systems that control blood pressure and heart rate.
When these two are used together, isocarboxazid can slow down how your body breaks down that stimulating effect. In some people this can push blood pressure up and trigger headaches or other symptoms. Because of that, this combination is considered one to avoid. The good news: this is manageable. Please don't stop either medicine on your own, but do talk with your doctor or pharmacist about your inhaler while you're on Marplan.
Interaction: Isocarboxazid (nonselective irreversible MAOI) with inhaled albuterol (beta-2 sympathomimetic). Concurrent use is rated contraindicated.
- Mechanism: MAO inhibition reduces metabolism of sympathomimetic amines, potentiating adrenergic/pressor effects.
- Effect/direction: Increased risk of hypertension, headache, and related sympathomimetic symptoms (increased drug effect).
- Evidence: Theoretical; some patients appear particularly susceptible.
- Onset: Unspecified.
- Management: Avoid combination where possible; if albuterol is clinically necessary, use lowest effective dose with close cardiovascular monitoring (BP, HR). Note that MAOI effects persist for up to 2 weeks after discontinuation.
What happens
An increased risk of hypertension, headache, and related symptoms
Interaction Deep Dive
Taking isocarboxazid at the same time as sympathomimetics (or with nonprescription products for colds, hay fever, or weight reduction that include vasoconstrictors) is contraindicated, since this combination can bring on hypertension, headache, and associated symptoms. Certain patients receiving isocarboxazid seem to be especially susceptible to sympathomimetic effects when the function of metabolizing enzymes is suppressed6.
Why it happens (mechanism)
Inhibition of metabolizing enzymes
How to manage this interaction
Your care team takes this pairing seriously because this combination is flagged as one to avoid. Here is how it's typically handled:
- Keep taking both exactly as prescribed until you speak with your prescriber, do not stop on your own.
- Your team may look at whether a different breathing medicine is a better fit, or watch you more closely (checking blood pressure and heart rate) if albuterol is still needed.
- Avoid over-the-counter cold, allergy, or weight-loss products with decongestants/vasoconstrictors while on isocarboxazid.
Call your doctor or pharmacist if you get a severe headache, pounding heartbeat, or a sudden blood pressure rise.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
3 reports — tap to read
a) The proposed mechanism for this interaction is thought to be catecholamine release triggered by the sympathomimetic agent. This leads to the liberation of a greater quantity of norEPINEPHrine, which subsequently becomes available to bind with the receptor 5.
b) Sympathomimetics that have indirect or mixed activity, such as ePHEDrine, trigger the release of norEPINEPHrine, and administration of monoamine oxidase inhibitors (MAOIs) makes more norEPINEPHrine available at nerve receptor sites by blocking the breakdown of catecholamines. Using the two together produces larger amounts of norEPINEPHrine, thereby heightening sympathetic activity 7.
c) Giving indirect-acting sympathomimetics together with MAOIs has led to serious hypertension 3482.
Common questions
Can I take Isocarboxazid and Albuterol Oral Inhalation together?
Combining isocarboxazid (Marplan) with albuterol can raise blood pressure and cause headaches, and it's flagged as a combination to avoid. Don't stop either drug on your own; talk with your doctor or pharmacist about the safest plan. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Isocarboxazid and Albuterol Oral Inhalation interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Isocarboxazid and Albuterol Oral Inhalation interaction managed?
Your care team takes this pairing seriously because this combination is flagged as one to avoid. Here is how it's typically handled: Keep taking both exactly as prescribed until you speak with your prescriber, do not stop on your own. Your team may look at whether a different breathing medicine is a better fit, or watch you more closely (checking blood pressure and heart rate) if albuterol is stil… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Isocarboxazid or Albuterol Oral Inhalation 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 (8)
- Product Information: AIRSUPRA(TM) oral inhalation aerosol, albuterol budesonide oral inhalation aerosol. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2023. DailyMed
- Horler AR & Wynne NA: Hypertensive crisis due to pargyline and metaraminol. Br Med J 1965; 2:460-461. PubMed
- Smookler S & Bermudez AJ: Hypertensive crisis resulting from an MAO inhibitor and an over-the-counter appetite suppressant. Ann Emerg Med 1982; 11:482-484. PubMed
- Cuthbert MF, Greenberg MP, & Morley SW: Cough and cold remedies: a potential danger to patients on monoamine oxidase inhibitors. Br Med J 1969; 1:404-406. PubMed
- Goldberg LI: Monoamine oxidase inhibitors. Adverse reactions and possible mechanisms. JAMA 1964; 190:456-462. DOI
- Product Information: MARPLAN oral tablets, isocarboxazid oral tablets. Validus Pharmaceuticals LLC (per Dailymed), Parsippany, NJ, 2023. DailyMed
- Gilman AG, Rall TW, Nies AS, et alGilman AG, Rall TW, Nies AS, et al (Eds): Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th. Publishing Co, New York, NY, 1990.
- Terry R, Kaye AH, & McDonald M: Sinutab (letter). Med J Aust 1975; 1:763.
Keep reading about Isocarboxazid
Keep reading about Albuterol Oral Inhalation
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