What the FDA labels say about taking them together
Fluoxetine and selegiline
Selegiline's FDA label of August 7, 2024 names fluoxetine in its warnings section; fluoxetine's label does not name selegiline itself but warns about its class (MAO inhibitors). The selegiline label: “EMSAM is contraindicated with selective serotonin reuptake inhibitors; serotonin and norepinephrine reuptake inhibitors; the tricyclic antidepressants clomipramine and imipramine, the opiate analgesics meperidine …”
Check it at the source: the fluoxetine FDA label on DailyMed (effective January 8, 2026, Dista Products Company); the selegiline FDA label on DailyMed (effective August 7, 2024, Rising Pharma Holdings, Inc.).
What does the fluoxetine label say about selegiline?
Fluoxetine's label does not name selegiline itself; it warns about its class (MAO inhibitors):
Fluoxetine label, contraindicationsInhibitors (MAOIs) The use of MAOIs intended to treat psychiatric disorders with PROZAC or within 5 weeks of stopping treatment with PROZAC is contraindicated because of an increased risk of serotonin syndrome.
Fluoxetine label, contraindicationsStarting PROZAC in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome [see Dosage and Administration ( 2.10 ) and Warnings and Precautions ( 5.2 )].
Source: FDA drug label (Prozac), NDA018936 (Eli Lilly And Co), as published by Dista Products Company, effective January 8, 2026 (SPL set c88f33ed-6dfb-4c5e-bc01-d8e36dd97299), via openFDA; the full label on DailyMed
What does the selegiline label say about fluoxetine?
Selegiline label, warningsSerious, sometimes fatal, reactions with signs and symptoms that may include hyperthermia, rigidity, myoclonus, autonomic instability with rapid fluctuations of the vital signs, and mental status changes that include extreme agitation progressing to delirium and coma have been reported with patients receiving a combination of fluoxetine hydrochloride and non-selective MAOIs.
Zelapar label (Bausch Health US, LLC, June 1, 2021), warnings and precautionsIn patients taking antidepressants with a long half-life (e.g., fluoxetine and its active metabolite), allow at least five weeks (perhaps longer, especially if fluoxetine has been prescribed chronically and/or at higher doses) to elapse between discontinuation of fluoxetine and initiation of ZELAPAR [see Drug Interactions (7.6) ].
Emsam label (Viatris Specialty LLC, May 15, 2020), contraindicationsEMSAM (selegiline transdermal system) is contraindicated with selective serotonin reuptake inhibitors (SSRIs, e.g., fluoxetine, sertraline, and paroxetine); serotonin and norepinephrine reuptake inhibitors (SNRIs, e.g., venlafaxine and duloxetine); the tricyclic antidepressants clomipramine and imipramine, the opiate analgesics meperidine, tramadol, methadone, pentazocine, and propoxyphene; and the antitussive agent dextromethorphan because of a risk of serotonin syndrome when EMSAM is used with these agents [see Warnings and Precautions (5.2) and Drug Interactions (7.1) ].
Source: FDA drug label (Zelapar, NDA021479), Bausch Health US, LLC, effective June 1, 2021 (SPL set 380d7717-2a79-42f3-a712-efe5e7696ba0), via openFDA
Source: FDA drug label (Emsam, NDA021336), Viatris Specialty LLC, effective May 15, 2020 (SPL set b891bd9f-fdb8-4862-89c5-ecdd700398a3), via openFDA
Source: FDA drug label (Selegiline Hydrochloride), Rising Pharma Holdings, Inc., effective August 7, 2024 (SPL set 23c4481f-d150-40c6-addb-b3e454ca914f), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Fluoxetine | Selegiline | |
|---|---|---|
| Labeled for | Depression, Anxiety, Bipolar disorder | Parkinson's disease, Depression |
| Boxed warning | Yes | No |
| Pharmacy cost (NADAC) | $0.0519 per capsule 40 mg capsule | $0.756 per capsule 5 mg capsule |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once