Procarbazine with Sumatriptan Interaction Details
Brand Names Associated with Procarbazine
- Matulane®
- Procarbazine
Brand Names Associated with Sumatriptan
- Imitrex® Tablets
- Sumatriptan
- Treximet® (as a combination product containing Naproxen, Sumatriptan)
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 29, 2023
Interaction Effect
Increased risk of serotonin syndrome (hypertension, hyperthermia, myoclonus, mental status changes)
Interaction Summary
Coadministration of sumatriptan and an MAOI, specifically an MAO-A inhibitor, or use of sumatriptan within 2 weeks of discontinuation of an MAO-A inhibitor is contraindicated. Wait at least 14 days after discontinuing an MAO-A inhibitor before initiating sumatriptan and at least 14 days after discontinuing sumatriptan before initiating therapy with an MAO-A inhibitor.
Severity
Contraindicated
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
The concurrent administration of sumatriptan and an MAOI, specifically an MAO-A inhibitor, or use of sumatriptan within 2 weeks of discontinuation of an MAO-A inhibitor is contraindicated. Wait at least 14 days after discontinuing an MAO-A inhibitor before initiating sumatriptan and at least 14 days after discontinuing sumatriptan before initiating therapy with an MAO-A inhibitor.
Mechanism Of Interaction
Inhibition of monoamine oxidase and increased serotonergic effect
Literature Reports
A) In a study involving 14 healthy female subjects, pretreatment with an MAO-A inhibitor decreased the clearance of sumatriptan. A 2-fold increase in the sumatriptan AUC, corresponding to a 40% increase in elimination half-life, was noted . In vitro studies with human microsomes suggested that sumatriptan is metabolized predominantly by MAO-A, and inhibitors of the MAO-A enzyme may increase systemic exposure of sumatriptan . The studies suggested MAO-B inhibitor did not cause a significant effect .
B) An approximately 7-fold increase in sumatriptan systemic exposure was noted when patients were given a sumatriptan 25-mg oral tablet following pretreatment with an MAO-A inhibitor in one small study .
C) At a large headache clinic, a retrospective chart review of 325 patients receiving sumatriptan and other antidepressants, beta-blockers, or calcium channel blockers for treatment of migraine was conducted. All 3 groups were compared and no statistically significant difference in pulse rate and blood pressure were noted. Headache recurrence rates were the same between groups. Significant adverse events were experienced by 2 patients. One patient received phenelzine 45 mg daily and sumatriptan while the second patient received sumatriptan alone. Both experienced abrupt decreases in blood pressure and pulse rate within minutes after the 6 mg subcutaneous administration of sumatriptan. In each case, the patient's vital signs returned to normal within 30 minutes .
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.
Sumatriptan Overview
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Sumatriptan is used to treat the symptoms of migraine headaches (severe, throbbing headaches that sometimes are accompanied by nausea or sensitivity to sound and light). Sumatriptan is in a class of medications called selective serotonin receptor agonists. It works by narrowing blood vessels in the head, 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. Sumatriptan 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.