Drug & supplement interaction

Tyramine + Selegiline

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

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

Tyramine has a major interaction with Selegiline. Concomitant use of tyramine with MAOIs may increase the risk of serious adverse effects from tyramine.

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

Tyramine and Selegiline

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

Major

MONOAMINE OXIDASE INHIBITORS (MAOIs)

Why this applies to Selegiline

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

Concomitant use of tyramine with MAOIs may increase the risk of serious adverse effects from tyramine.
Tyramine is metabolized by monoamine oxidase. Concurrent use of MAOIs with tyramine can lead to elevated levels of tyramine in the body. This can increase the effects of tyramine, which has been reported to cause hypertension, headache, and hypertensive crisis in numerous cases. Sensitivity to tyramine can increase up to 10-fold to 100-fold in people using an MAOI. The European Food Safety Authority states that meals containing more than 50 mg of tyramine might present a risk to patients that are using third generation MAOI medications. Meals containing more than 6 mg of tyramine are likely to present a risk to patients who are taking classic MAOI medications.
Severity Major Likelihood Likely Evidence B

Well-controlled human studies have demonstrated the likely existence of this interaction.

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

Here's the key thing with selegiline: it blocks one of the enzymes (monoamine oxidase) your body normally uses to break down tyramine from food. So when you eat tyramine-rich items like aged cheese, cured or fermented meats, sauerkraut, soy sauce, or tap/draft beer, the tyramine can build up instead of being cleared. That extra tyramine can trigger a sudden, dangerous spike in blood pressure, sometimes called a hypertensive crisis, along with a pounding headache, sweating, a racing heart, or chest pain.

At low everyday doses, selegiline is fairly selective and the risk is smaller, but at higher doses (and especially with the Emsam patch) it acts more like a classic MAOI, where even modest amounts of tyramine matter. Please don't change your diet or your dose on your own. Ask your pharmacist or doctor which foods you need to limit.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. VanDenBerg CM, Blob LF, Kemper EM, Azzaro AJ. Tyramine pharmacokinetics and reduced bioavailability with food. J Clin Pharmacol. 2003;43(6):604-9. DOI
  2. Peet M, Yates RA, Carroll JA, Middlemiss DN. The interaction of tyramine with a single dose of tranylcypromine in healthy volunteers. Br J Clin Pharmacol. 1981;11(2):212-4. PubMed
  3. Rapaport MH. Dietary restrictions and drug interactions with monoamine oxidase inhibitors: the state of the art. J Clin Psychiatry. 2007;68 Suppl 8:42-6.
  4. European Food Safety Authority. Scientific opinion on risk based control of biogenic amine formation in fermented foods. EFSA Journal. 2011;9(10):2393. DOI

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

Tyramine Also Interacts With Other Medications

Tyramine has 180 major, 1 moderate, 171 minor 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.

Major 180 Moderate 1 Minor 171 No known interaction 2,478 (incl. Selegiline)
Taking anything else?

Check Another of Your Medications Against Tyramine

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

From our Q&A

Questions About Tyramine or Selegiline

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Tyramine or Selegiline, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Selegiline

This page covers Tyramine 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

One more smart check

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

We hold 20 real supplement products containing Tyramine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tyramine. Your product may carry other ingredients that interact with Selegiline too, on top of Tyramine — 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 Tyramine 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 Tyramine
Steady interest

#1,038 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Selegiline
Steady interest

#2,155 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 Tyramine

What is Tyramine?

  • Studied for effects on blood pressure
  • Discussed in relation to migraine and headache triggers
  • Of interest in food and diet science
  • Subject of research on the nervous system

Tyramine is a natural compound formed when certain proteins break down, and it is found in aged cheeses, cured meats, fermented foods, and some other items. It is not a typical health supplement and is best known for the problems it can cause—such as dangerous spikes in blood pressure—in people taking certain medications or in those who are sensitive to it. If you have been told to follow a low-tyramine diet, talk with your pharmacist or doctor before making changes.

Read the full Tyramine 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 & Tyramine

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

180Major
1Moderate
171Minor
2,477No known interaction
180 Major 1 Moderate 171 Minor 2,477 No interaction
Major

180 interactions

Showing 60 of 180 major interactions — see all 180 on the Tyramine page.

Moderate

1 interaction

Minor

171 interactions

Showing 60 of 171 minor interactions — see all 171 on the Tyramine page.

No interaction 2,477 drugs checked — show the list

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

Showing the 60 most looked-up of 2,477 medications checked with no known interaction — see the full Tyramine list.

See the full Tyramine interactions page
See every supplement checked against Selegiline, 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
Tyramine monograph › Uses, safety, and every drug interaction in one place Selegiline supplement interactions › Every supplement checked against Selegiline, ranked by severity Selegiline 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 Tyramine and Selegiline Together: Common Questions

Can you take Tyramine with Selegiline?
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 Tyramine and Selegiline 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 Selegiline and Tyramine?

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.