Drug & supplement interaction

Hordenine + Isocarboxazid

Isocarboxazid brand name: Marplan.

Moderate Interaction
The bottom line Moderate

Hordenine has a moderate interaction with Isocarboxazid. Hordenine is structurally similar to tyramine In vitro research shows that hordenine is a selective substrate for monoamine oxidase-B in the liver.

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

Hordenine and Isocarboxazid

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

Moderate

MONOAMINE OXIDASE INHIBITORS (MAOIs)

Why this applies to Isocarboxazid

Isocarboxazid falls under MONOAMINE OXIDASE INHIBITORS (MAOIs) — the group Hordenine interacts with.

Hordenine is structurally similar to tyramine In vitro research shows that hordenine is a selective substrate for monoamine oxidase-B in the liver. Theoretically, concomitant use of hordenine with MAOIs might increase blood pressure, potentially leading to a hypertensive crisis.
Some MAOIs include isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate).
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

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

Here's the concern with pairing hordenine and Marplan (isocarboxazid). Marplan is a powerful MAO inhibitor, meaning it blocks the very enzyme your body uses to break down certain stimulant-like chemicals. Hordenine is chemically similar to tyramine, the compound behind the famous "cheese reaction" that people on MAOIs are warned about. In theory, if your body can't clear hordenine normally, it could build up and push your blood pressure up sharply.

That kind of spike, called a hypertensive crisis, can cause a pounding headache, neck stiffness, chest pain, or a racing heart, and it's a true emergency. I'll be honest that this warning is theoretical, based on how these substances behave in the lab rather than real cases. Still, because Marplan leaves so little safety margin, I'd avoid combining them and check with your doctor or pharmacist first.

References
  1. Barwell CJ, Basma AN, Lafi MA, Leake LD. Deamination of hordenine by monoamine oxidase and its action on vasa deferentia of the rat. J Pharm Pharmacol 1989;41(6):421-3. PubMed
  2. Nelson BC, Putzbach K, Sharpless KE, Sander LC. Mass spectrometric determination of the predominant adrenergic protoalkaloids in bitter orange (Citrus aurantium). J Agric Food Chem 2007;55(24):9769-75. 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

Hordenine Also Interacts With Other Medications

Hordenine has 179 moderate, 149 minor known drug interactions in our database — the Isocarboxazid 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 Hordenine

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

Everything else you take

See Every Supplement That Interacts With Isocarboxazid

This page covers Hordenine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Isocarboxazid page lists 81 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 14 major · 55 moderate · 12 minor.

From our pharmacist’s overview on the Isocarboxazid page

“Isocarboxazid (Marplan) is an MAOI antidepressant, and that drug class carries some of the sharpest supplement and food hazards in the pharmacy, so read this list closely rather than skimming it. Fourteen of the 81 entries rate major, and most of the danger runs through tyramine.”

Reviewed by 2 · Jul 18, 2026

Open the Isocarboxazid interaction page

One more smart check

Taking Hordenine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 339 real supplement products containing Hordenine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hordenine. Your product may carry other ingredients that interact with Isocarboxazid too, on top of Hordenine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Hordenine and Isocarboxazid 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 Hordenine
Top 25%

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

29 days ago today
Medication Isocarboxazid
Steady interest

#2,435 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 Hordenine

What is Hordenine?

Hordenine
  • Energy and stimulation
  • Athletic and workout performance
  • Weight loss/fat burning
  • Focus and mood
  • Appetite control

Hordenine is a natural alkaloid found in barley and some cacti that is marketed as a stimulant for energy, focus, and fat loss, but solid human evidence for these benefits is lacking. Its safety in people has not been well studied, so caution is warranted, and it should be avoided in pregnancy, breastfeeding, and by people with heart conditions.

Read the full Hordenine monograph & all interactions
Medication

About Isocarboxazid

What Is Isocarboxazid Used For?

Brand name: Marplan

Marplan (isocarboxazid) is indicated for the treatment of depression — specifically, major depressive disorder. Because it carries serious risks, it is not a first-choice antidepressant. Marplan is generally reserved for patients who have not responded adequately to other antidepressants.

Clinical trials showed Marplan to be effective in adult outpatients with major depressive disorder, including those whose depression was accompanied by anxiety symptoms such as panic or phobias. Marplan is not approved for use in children or adolescents.

See full Isocarboxazid drug information
Keep checking

Other Drugs & Hordenine

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

0Major
179Moderate
149Minor
2,501No known interaction
Moderate

179 interactions

Showing 60 of 179 moderate interactions — see all 179 on the Hordenine page.

Minor

149 interactions

Showing 60 of 149 minor interactions — see all 149 on the Hordenine page.

No interaction 2,501 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 Hordenine and Isocarboxazid Together: Common Questions

Can you take Hordenine with Isocarboxazid?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Hordenine and Isocarboxazid interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Isocarboxazid and Hordenine?

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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.