Procarbazine with Rizatriptan Interaction Details
Brand Names Associated with Procarbazine
- Matulane®
- Procarbazine
Brand Names Associated with Rizatriptan
- Maxalt-MLT®
- Maxalt®
- Rizatriptan
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 29, 2023
Interaction Effect
An increased risk of serotonin syndrome
Interaction Summary
Concomitant use of rizatriptan with a MAO-A inhibitor or a non-selective MAO inhibitor, or use of rizatriptan within 2 weeks of discontinuing a MAO-A inhibitor or a non-selective MAO inhibitor, is contraindicated due to a risk of increased rizatriptan plasma concentrations, additive serotonergic effects and increased risk of serotonin syndrome. Concurrent use of an MAOI and a serotonin 5-HT1 receptor agonist (such as rizatriptan) is contraindicated unless patient is closely observed for signs and/or symptoms of serotonin syndrome. If concomitant use is clinically warranted, monitor for signs and symptoms of serotonin syndrome, such as neuromuscular abnormalities (including hyperreflexia, tremor, muscle rigidity, clonus, peripheral hypertonicity, and shivering), autonomic hyperactivity (including tachycardia, mydriasis, diaphoresis, the presence of bowel sounds, and diarrhea), and mental status changes (including agitation and delirium). Serotonin syndrome can be life-threatening . The onset of symptoms can occur within minutes to hours of receiving a new or a greater dose of a serotonergic medication. Discontinue use of rizatriptan if serotonin syndrome is suspected .
Severity
Contraindicated
Onset
Rapid
Evidence
Probable
How To Manage Interaction
Concomitant use of rizatriptan with a MAO-A inhibitor or a non-selective MAO inhibitor, or use of rizatriptan within 2 weeks of discontinuing a MAO-A inhibitor or a non-selective MAO inhibitor, is contraindicated due to a risk of increased rizatriptan plasma concentrations, additive serotonergic effects and increased risk of serotonin syndrome. Concurrent use of an MAOI and a serotonin 5-HT1 receptor agonist (such as rizatriptan) is contraindicated unless patient is closely observed for signs and/or symptoms of serotonin syndrome. If concomitant use is clinically warranted, monitor for signs and symptoms of serotonin syndrome, such as neuromuscular abnormalities (including hyperreflexia, tremor, muscle rigidity, clonus, peripheral hypertonicity, and shivering), autonomic hyperactivity (including tachycardia, mydriasis, diaphoresis, the presence of bowel sounds, and diarrhea), and mental status changes (including agitation and delirium). Serotonin syndrome can be life-threatening . The onset of symptoms can occur within minutes to hours of receiving a new or a greater dose of a serotonergic medication. Discontinue use of rizatriptan if serotonin syndrome is suspected .
Mechanism Of Interaction
Additive serotonergic effects
Literature Reports
A) Administration of moclobemide 150 mg three times daily for four days and a single dose of rizatriptan 10 mg on day 4 significantly increased the area under the concentration-time curve (AUC) of rizatriptan by 119% in twelve healthy volunteers during a double-blind, randomized, placebo-controlled, two-period, crossover study. Maximum concentration (Cmax) of rizatriptan also increased by 41% (22.6 ng/mL vs. 31.3 ng/mL), and the AUC of the active N-monodesmethyl metabolite was increased by more than 400% (2.8 ng/mL vs. 7.2 ng/mL). Moclobemide is a selective, reversible inhibitor of monoamine oxidase-A, and the interaction with rizatriptan is expected to be even greater with irreversible MAO inhibitors. No pharmacokinetic interaction is expected between rizatriptan and a selective monoamine oxidase-B inhibitor .
B) Spontaneous reports of serotonin syndrome associated with the coadministration of linezolid and serotonergic agents have been reported .
Procarbazine Overview
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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.
Rizatriptan Overview
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Rizatriptan is used to treat the symptoms of migraine headaches (severe, throbbing headaches that sometimes are accompanied by nausea and sensitivity to sound and light). Rizatriptan is in a class of medications called selective serotonin receptor agonists. It works by narrowing blood vessels in the brain, stopping pain signals from being sent to the brain, and blocking the release of certain natural substances that cause pain, nausea, and other symptoms of migraine. Rizatriptan does not prevent migraine attacks or reduce the number of headaches you have.
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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.