Drug & supplement interaction

Tianeptine + Tranylcypromine

Tranylcypromine brand name: Parnate.

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

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

Read the full interaction report
SeverityMajor
LikelihoodProbable
EvidenceC
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Tianeptine and Tranylcypromine

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

Major

MONOAMINE OXIDASE INHIBITORS (MAOIs)

Why this applies to Tranylcypromine

Tranylcypromine 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 really direct here: pairing tianeptine with tranylcypromine (Parnate) is a dangerous combination. Parnate is an MAOI, which means it slows down how your body breaks down brain chemicals like serotonin and norepinephrine. When you add tianeptine on top of that, those signals can pile up too far, and experts agree this can lead to serious trouble like a sudden spike in blood pressure, high fever, seizures, an unsafe heart response, and in the worst cases, death.

This isn't a theoretical worry; it's a recognized, serious interaction. Remember too that tianeptine is not FDA-approved and acts like an opioid at higher doses, which only adds risk. Please don't combine these. Talk with your doctor or pharmacist before using any tianeptine product while you're on Parnate.

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 Tranylcypromine 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. Tranylcypromine)
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 Tranylcypromine

This page covers Tianeptine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tranylcypromine 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 Tranylcypromine page

“Tranylcypromine (Parnate) belongs to the MAOI class of antidepressants, and I read its supplement list with real seriousness, since the highest-rated entries can turn dangerous quickly. The drug blocks the enzyme that normally clears tyramine, so tyramine-rich items like brewer's yeast, fermented soy, and even beer or wine can push blo…”

Reviewed by 2 · Jul 18, 2026

Open the Tranylcypromine interaction page

How much people look this up

Where Tianeptine and Tranylcypromine 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

#1,077 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tranylcypromine
Top half

#1,268 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 Tranylcypromine

What Is Tranylcypromine Used For?

Brand name: Parnate

Tranylcypromine tablets — sold as Parnate, Tranylcypromine, and Tranylcypromine Sulfate — are used to treat major depressive disorder (MDD) in adults. It is not a first-choice antidepressant; it is specifically for people who have already tried other antidepressants and have not gotten adequate relief.

Because of its serious potential side effects, strict dietary requirements, and many drug interactions, tranylcypromine is reserved for cases where other treatments have not worked. It is not approved for use in children.

See full Tranylcypromine 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 Tranylcypromine, 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 Tranylcypromine supplement interactions › Every supplement checked against Tranylcypromine, ranked by severity Tranylcypromine 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 Tranylcypromine Together: Common Questions

Can you take Tianeptine with Tranylcypromine?
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 Tranylcypromine 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 Tranylcypromine and Tianeptine?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.