MAOIs are not recommended for use with medications like pseudoephedrine, phenylephrine, ephedrine, and phenylpropanolamine. The combination of MAO inhibitors and these drugs can cause an acute hypertensive episode.
Monoamine oxidase also breaks down tyramine, a chemical present in aged cheese, wines, and other aged foods. Since MAOIs inhibit monoamine oxidase, they decrease the breakdown of tyramine from ingested food, thus increasing the level of tyramine in the body. Excessive tyramine can elevate blood pressure and cause a hypertensive crisis. Patients treated with MAOIs should adhere to recommended dietary modifications that reduce the intake of tyramine.
What about taking MAOIs during pregnancy or while breastfeeding?
The FDA classifies MAO inhibitors in pregnancy category C, which means that there is no established evidence of safe and effective use of MAO inhibitor in pregnant women. Therefore, infant risk cannot be ruled out. It is not known whether MAO inhibitors enter breast milk; however, MAO inhibitors should be avoided in nursing mothers to avoid harm to the fetus.
Medically reviewed by Omudhome Ogbru, PharmD
REFERENCE: UpToDate. Monoamine oxidase inhibitors (MAOIs) for treating depressed adults.
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