Drug & supplement interaction

Beer + Selegiline

Selegiline brand names: Carbex, Eldepryl, Emsam, Zelapar.

Major Interaction
The bottom line Major

Beer has a major interaction with Selegiline. Concomitant use may cause hypertensive crisis.

Read the full interaction report
SeverityMajor
LikelihoodProbable
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Beer and Selegiline

Here is the interaction we found between these two, with the evidence behind it.

Major

MONOAMINE OXIDASE INHIBITORS (MAOIs)

Why this applies to Selegiline

Selegiline falls under MONOAMINE OXIDASE INHIBITORS (MAOIs) — the group Beer interacts with.

Concomitant use may cause hypertensive crisis.
Beer contains tyramine, which is metabolized by monoamine oxidase. Concurrent use of MAOIs with tyramine-containing beverages can lead to elevated levels of tyramine in the body. This can increase the effects of tyramine, which has been reported to cause hypertension, headache, and hypertensive crisis in numerous cases. Sensitivity to tyramine can increase up to 10-fold to 100-fold in people using an MAOI.
Severity Major Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the deal with beer and selegiline. Selegiline is an MAO-B inhibitor, and your body normally uses MAO enzymes to break down a compound called tyramine, which shows up in fermented foods and drinks like beer (especially tap, unfiltered, or craft varieties). When that enzyme is blocked, tyramine can pile up and shove your blood pressure suddenly upward.

The worry is a hypertensive crisis: a pounding headache, neck stiffness, sweating, a racing or thumping heart, and dangerously high blood pressure. At the usual low Parkinson's dose, selegiline stays fairly MAO-B selective, so the risk is lower than with older MAOIs, but it climbs at higher doses. This caution is based mainly on pharmacology and known tyramine reactions, not big trials. Please don't change anything on your own. Talk with your pharmacist or doctor about how much beer, if any, is safe for you.

References
  1. VanDenBerg CM, Blob LF, Kemper EM, Azzaro AJ. Tyramine pharmacokinetics and reduced bioavailability with food. J Clin Pharmacol. 2003;43(6):604-9. DOI
  2. Peet M, Yates RA, Carroll JA, Middlemiss DN. The interaction of tyramine with a single dose of tranylcypromine in healthy volunteers. Br J Clin Pharmacol. 1981;11(2):212-4. PubMed
  3. Rapaport MH. Dietary restrictions and drug interactions with monoamine oxidase inhibitors: the state of the art. J Clin Psychiatry. 2007;68 Suppl 8:42-6.
  4. Miraghajani M, Momenyan S, Arab A, Hasanpour Dehkordi A, Symonds ME. Blueberry and cardiovascular disease risk factors: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2020;53:102389. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Beer Also Interacts With Other Medications

Beer has 653 major, 272 moderate known drug interactions in our database — the Selegiline one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Beer

Covers the 2,830 medications we’ve checked against Beer. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Selegiline

This page covers Beer only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Selegiline page lists 102 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Bitter Orange (major), Brewer's Yeast (major), Cowhage (major) and Fever Bark (major).

By severity: 14 major · 75 moderate · 13 minor.

Open the Selegiline interaction page

How much people look this up

Where Beer and Selegiline Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Beer
Top 25%

#330 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Selegiline
Steady interest

#2,223 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Beer

What is Beer?

Beer
  • Social and recreational drinking
  • Relaxation
  • Heart health (popular belief)
  • Bone health (popular belief)
  • Source of antioxidants and B vitamins

Beer is an alcoholic beverage that contains some minerals, B vitamins, and plant compounds from hops and grain, but it is not a health supplement. Any possible benefits come only from light-to-moderate intake, and they are easily outweighed by the well-known harms of alcohol. The safest amount of alcohol for health is none, and beer should be avoided in pregnancy and breastfeeding.

Read the full Beer monograph & all interactions
Medication

About Selegiline

What Is Selegiline Used For?

Brand names: Carbex, Eldepryl, Emsam, Zelapar

Selegiline is used as an add-on treatment for people with Parkinson's disease who are already taking levodopa/carbidopa but are finding that the medication's effects are wearing off or becoming less reliable. It is not used alone — it only works as part of a combination approach.

In clinical studies, adding selegiline helped reduce the amount of daily levodopa needed, cut down on "off" time (periods when symptoms break through), and improved things like tremor, speech, movement, and overall daily function.

See full Selegiline drug information
Keep checking

Other Drugs & Beer

Browse every other medication we’ve checked against Beer — both the ones with a known interaction and the ones without. Select any drug for the full detail.

653Major
272Moderate
0Minor
1,904No known interaction
Major

653 interactions

Showing 60 of 653 major interactions — see all 653 on the Beer page.

Moderate

272 interactions

Showing 60 of 272 moderate interactions — see all 272 on the Beer page.

No interaction 1,904 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Beer and Selegiline Together: Common Questions

Can you take Beer with Selegiline?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Beer and Selegiline interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.