Drug & supplement interaction

Tianeptine + Isocarboxazid

Isocarboxazid brand name: Marplan.

Major Interaction
Medically reviewed by · Updated September 2026
The bottom line Major

Tianeptine has a major interaction with Isocarboxazid. Tianeptine may increase the toxicity of MAOIs.

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

Tianeptine and Isocarboxazid

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

Major

MONOAMINE OXIDASE INHIBITORS (MAOIs)

Why this applies to Isocarboxazid

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

Tianeptine may increase the toxicity of MAOIs.
Concomitant use of tianeptine and non-selective MAOIs might increase the risk of cardiovascular collapse, hypertension, fever, convulsions, and death.
Severity Major Likelihood Probable Evidence C

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

I want to be very direct with you here, because this pairing is genuinely dangerous. Marplan (isocarboxazid) is an MAO inhibitor, which means it blocks the enzyme that normally breaks down brain chemicals like serotonin and norepinephrine. Tianeptine also stirs up these same brain systems. Put the two together and those signals can pile up far too high.

When that happens, you can see a serotonin-storm type reaction: a dangerous spike in blood pressure, high fever, racing or irregular heartbeat, seizures, and in the worst cases the heart and circulation can collapse. This is a major, well-recognized risk, not a theory. Please do not combine them. Tianeptine in over-the-counter products is risky on its own, so talk with your doctor or pharmacist before going anywhere near it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Summary of Product Characteristics Stablo: Tianeptine. 2008. Available at: https://www.servier.com.ve/sites/default/files/spc-pil/spc-stablon.pdf

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

Tianeptine Also Interacts With Other Medications

Tianeptine has 8 major, 268 moderate 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.

Major 8 Moderate 268 No known interaction 2,554 (incl. Isocarboxazid)
Taking anything else?

Check Another of Your Medications Against Tianeptine

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

Everything else you take

See Every Supplement That Interacts With Isocarboxazid

This page covers Tianeptine 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

How much people look this up

Where Tianeptine 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 Tianeptine
Steady interest

#1,047 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Isocarboxazid
Steady interest

#2,534 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 Tianeptine

What is Tianeptine?

  • Depression (prescription use in some countries)
  • Anxiety
  • Mood enhancement
  • Pain relief
  • Self-treatment of opioid withdrawal
  • Recreational euphoria

Tianeptine is a prescription antidepressant in some countries, but it is NOT approved by the FDA in the United States and is illegally sold in dietary supplements and 'gas station' products. At high doses it acts like an opioid and carries serious risks of addiction, overdose, and dangerous withdrawal. We strongly advise against using over-the-counter tianeptine products and urge anyone considering it to talk with a doctor or pharmacist first.

Read the full Tianeptine 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 & Tianeptine

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

8Major
268Moderate
0Minor
2,553No known interaction
8 Major 268 Moderate 2,553 No interaction
Major

8 interactions

Moderate

268 interactions

Showing 60 of 268 moderate interactions — see all 268 on the Tianeptine page.

No interaction 2,553 drugs checked — show the list

We also checked Tianeptine against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,553 medications checked with no known interaction — see the full Tianeptine list.

See the full Tianeptine interactions page
See every supplement checked against Isocarboxazid, ranked by severity
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

Keep exploring
Tianeptine monograph › Uses, safety, and every drug interaction in one place Isocarboxazid supplement interactions › Every supplement checked against Isocarboxazid, ranked by severity Isocarboxazid drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Tianeptine and Isocarboxazid Together: Common Questions

Can you take Tianeptine with Isocarboxazid?
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 Tianeptine and Isocarboxazid 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

Still Have a Question About Isocarboxazid and Tianeptine?

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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.