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Re: Triptans and MAOIs » Donna Louise

Posted by ed_uk on May 10, 2006, at 9:43:02

In reply to Re: Triptans and MAOIs » ed_uk, posted by Donna Louise on May 9, 2006, at 23:00:15

>I thought the reason you couldn't take a triptan with an MAOI is because the triptan (drug) needed the MAO to deamimate it and my brain would be rife with triptans.

The interaction between MAOIs and rizatriptan seems to be the greatest. Nevertheless, when rizatriptan was given with moclobemide (an MAOI) in a clinical study, no unusual side effects occured, despite the increased blood levels of rizatriptan. Still, I would not recommend combining rizatriptan with an MAOI, because the blood level of rizatriptan is significantly increased.

MAOIs don't affect the metabolism of Axert very much at all. RE the interaction between moclobemide (an MAOI) and Axert, the manufacturer of Axert says:

'No clinically significant interactions were observed'

Almotriptan (Axert) seems like a good choice for two reasons:

1. The blood level of almotriptan is only slightly increased by MAOIs.

2. Almotriptan does not enter the brain in significant quantities. This might theoretically reduce the risk of a 'central' interaction between almotriptan and MAOIs, although there is no evidence that such an interaction can occur. Triptans work on the blood vessels, not on the brain itself. Some triptans (eg. sumatriptan and almotriptan) do not enter the brain. Other triptans (eg. eletriptan) enter the brain much more readily.

Ed


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