Drug & supplement interaction

Khat + Selegiline

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

Moderate Interaction
The bottom line Moderate

Khat has a moderate interaction with Selegiline. In one case report, a 24-year-old man developed reversible cerebral vasoconstriction syndrome (RCVS) thought to be caused by chewing khat in combination with treatment with tranylcypromine, an MAOI.

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

Khat and Selegiline

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

Moderate

MONOAMINE OXIDASE INHIBITORS (MAOIs)

Why this applies to Selegiline

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

In one case report, a 24-year-old man developed reversible cerebral vasoconstriction syndrome (RCVS) thought to be caused by chewing khat in combination with treatment with tranylcypromine, an MAOI. Theoretically, the combination of khat and an MAOI might increase the induction of sympathetic stimulation, increasing the risk of vasoconstriction. Until more is known, avoid khat in patients taking MAOIs and for 14 days after MAOI discontinuation.
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 simple version: Selegiline is an MAO-B inhibitor, meaning it slows down one of your body's natural systems for breaking down stimulant-type brain chemicals like dopamine and norepinephrine. Khat does the opposite, it floods your system with those same chemicals because of its amphetamine-like compounds (cathinone and cathine). Put them together and the stimulant effect can pile up with nowhere to go, which can spike blood pressure and tighten blood vessels. There's a reported case where this kind of pairing was linked to severe blood vessel narrowing in the brain.

To be fair, this is based on a single anecdotal case, so it's not common, but the theory makes biological sense and the stakes are high. Khat is also illegal in the U.S. The safe move is to avoid it entirely while on selegiline, and please check with your pharmacist or doctor with any questions.

References
  1. Tuladhar AM, Boogaarts HD, de Leeuw FE, van Dijk E. Reversible cerebral vasoconstriction syndrome after chewing khat leaves. Cerebrovasc Dis. 2013;36(2):158-9. 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

Khat Also Interacts With Other Medications

Khat has 4 major, 400 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 Khat

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

Everything else you take

See Every Supplement That Interacts With Selegiline

This page covers Khat 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), Beer (major), Bitter Orange (major), Brewer's Yeast (major) and Cowhage (major).

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

Open the Selegiline interaction page

How much people look this up

Where Khat 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 Khat
Top half

#464 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 Khat

What is Khat?

Khat
  • Stimulant for energy and alertness
  • Euphoria and mood elevation
  • Reducing fatigue
  • Appetite suppression
  • Social and traditional ceremonies

Khat is a plant chewed for its amphetamine-like stimulant effects, but it carries serious risks including high blood pressure, heart problems, mental health effects, and dependence. It is a controlled substance and illegal in the United States and many other countries, so it should not be used.

Read the full Khat 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 & Khat

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

4Major
400Moderate
0Minor
2,425No known interaction
Major

4 interactions

Moderate

400 interactions

Showing 60 of 400 moderate interactions — see all 400 on the Khat page.

No interaction 2,425 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 Khat and Selegiline Together: Common Questions

Can you take Khat with Selegiline?
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 Khat and Selegiline 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

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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.