Procarbazine with Opipramol Interaction Details
Brand Names Associated with Procarbazine
- Matulane®
- Procarbazine
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 29, 2023
Interaction Effect
Neurotoxicity, seizures, or serotonin syndrome (hypertension, hyperthermia, myoclonus, mental status changes)
Interaction Summary
Concomitant TCA and MAOI use has resulted in hyperpyrexia, convulsions, and death. Concurrent use of MAOIs and TCAs has also been reported to result in a condition termed serotonin syndrome. Serotonin syndrome is a rare but potentially fatal condition of serotonergic hyperstimulation characterized by hypertension, hyperthermia, myoclonus, and changes in mental status . Although opipramol does not block the neuronal uptake of norepinephrine or serotonin, the concurrent use of opipramol and MAOIs is contraindicated .
Severity
Contraindicated
Onset
Delayed
Evidence
Probable
How To Manage Interaction
Concomitant use of opipramol and a monoamine oxidase inhibitor (MAOI) is contraindicated.
Mechanism Of Interaction
Unknown
Literature Reports
A) Concomitant administration of monoamine oxidase inhibitors (MAOIs) with tricyclic antidepressants (TCAs) has been considered an absolute contraindication in the past and still is listed as such by the manufacturers. Reports of excitation, hyperpyrexia, convulsions, and possible death have been attributed to the combination . However, there is evidence that MAOIs and TCAs can be given concomitantly in patients previously unresponsive to the MAOI or TCA alone. A few precautions must be followed including: a) avoidance of large doses (no more than 150 mg amitriptyline or its equivalent, 45 mg phenelzine, or 60 mg isocarboxazid) b) oral administration c) avoidance of clomipramine, imipramine, desipramine, and tranylcypromine in any combination, and d) close monitoring of patients . The combination may be utilized in one of two ways. Most frequently, the recommendation is to stop all previous antidepressants (five to ten days for TCAs and 14 days for MAOIs); the combination is then simultaneously started . Alternatively, in a patient previously receiving a TCA, small doses of the MAOI may be slowly added (Schoonover, 1983). Some sources suggest that the combination of amitriptyline and isocarboxazid is preferred . Numerous studies in patients with refractory depression or phobic anxiety states have successfully used the combination of MAOIs and TCAs .
Procarbazine Overview
-
Procarbazine is used in combination with other medications to treat certain types of Hodgkins disease (types of cancer that begin in a type of white blood cells that normally fights infection). Procarbazine is in a class of medications called alkylating agents. It works by slowing or stopping the growth of cancer cells in your body.
Return To Our Drug Interaction Homepage
Feedback, Question Or Comment About This Information?
Ask Dr. Brian Staiger, PharmD, our medical editor, directly! He's always more than happy to assist.
Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.