Drug & supplement interaction

Tianeptine + Ozanimod Hydrochloride

Ozanimod Hydrochloride brand name: Zeposia.

Major Interaction
The bottom line Major

Tianeptine has a major interaction with Ozanimod Hydrochloride. 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 Ozanimod Hydrochloride

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

Major

MONOAMINE OXIDASE INHIBITORS (MAOIs)

Why this applies to Ozanimod Hydrochloride

Ozanimod Hydrochloride 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

Here's something worth knowing about Zeposia (ozanimod). One of the breakdown products of this MS and ulcerative colitis drug actually blocks an enzyme called MAO (monoamine oxidase). That's why it gets grouped with MAO inhibitors when we check for interactions. Tianeptine, on the other hand, is an unapproved substance often sold illegally in 'gas station' products, and combining it with something that has MAO-blocking activity is a real concern.

When you slow down MAO and add tianeptine, the worry is a dangerous buildup that can lead to spikes in blood pressure, fever, seizures, and in the worst cases cardiovascular collapse. This is flagged as a major, serious combination. Please don't use any tianeptine product, and talk with your doctor or pharmacist about anything you're taking alongside Zeposia.

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 Ozanimod Hydrochloride 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 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 Ozanimod Hydrochloride

This page covers Tianeptine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ozanimod Hydrochloride page lists 159 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Beer (major) and Bitter Orange (major).

By severity: 20 major · 127 moderate · 12 minor.

From our pharmacist’s overview on the Ozanimod Hydrochloride page

“People taking ozanimod (Zeposia) for multiple sclerosis or ulcerative colitis often reach for immune boosters, protein powders, or herbal energy blends, and that is where this list demands real attention. Twenty of the 159 supplements on file carry a major rating, and the loudest theme is blood pressure.”

Reviewed by 2 · Jul 18, 2026

Open the Ozanimod Hydrochloride interaction page

How much people look this up

Where Tianeptine and Ozanimod Hydrochloride 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

#1,071 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ozanimod Hydrochloride
Steady interest

#2,209 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 Ozanimod

What Is Ozanimod Used For?

Brand name: Zeposia

Zeposia (ozanimod) is approved for adults with relapsing forms of multiple sclerosis (MS) — including clinically isolated syndrome, relapsing-remitting MS, and active secondary progressive MS.

Zeposia is also approved for adults with moderately to severely active ulcerative colitis (UC), a chronic inflammatory bowel disease.

See full Ozanimod 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
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
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 Tianeptine and Ozanimod Hydrochloride Together: Common Questions

Can you take Tianeptine with Ozanimod Hydrochloride?
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 Ozanimod Hydrochloride 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 Ozanimod Hydrochloride 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.