Moclobemide - Contraindications and Cautions

Contraindications and Cautions

Contraindications:

The combination of moclobemide with prescription or over the counter sympathomimetic drugs is not recommended due to the potential of significant drug interactions.

  • Hypersensitivity to moclobemide
  • States of severe confusion
  • While moclobemide or the irreversible MAO-B selective inhibitor selegiline taken alone has very little pressor effect, and requires no dietry restriction, the combination of seligiline with moclobemide leads to a significant enhancement of the pressor effect and such a combination requires dietary restriction of foods containing high amounts of tyramine. The combination of moclobemide and a reversible MAO-B inhibitor requires tyramine dietary restrictions.
  • Concomitant treatment with clomipramine
  • Combination treatment with pethidine (Interaction may be fatal)
  • Combination treatment with dextromethorphan
  • Pediatric patients (no sufficient data exists)

Caution:

Using moclobemide in combination with drugs which enhance serotonin require caution. Individuals who have liver impairment may require dose reduction of about one half or one third.

  • Concomitant treatment with SSRIs may lead to a serotonin syndrome. After termination of SSRI treatment, moclobemide should not be used until four to five half-lives of the SSRI have elapsed (five weeks in the case of fluoxetine and two weeks otherwise).
  • Patients with schizophrenia (psychosis may exacerbate, longterm treatment with neuroleptics should be continued.)
  • Patients with hyperthyroidism (overfunction of the thyroid gland) and phaeochromocytoma. Hypertensive reactions are possible, therefore treatment with moclobemide cannot be recommended.
  • Patients with uncontrolled hypertension
  • Patients with bipolar disorder.

Read more about this topic:  Moclobemide