What the FDA labels say about taking them together
Meperidine and selegiline
Selegiline's FDA label of August 7, 2024 names meperidine in its contraindications section; meperidine's label does not name selegiline itself but warns about its class (MAO inhibitors). The selegiline label: “Selegiline is contraindicated for use with meperidine.”
Check it at the source: the meperidine FDA label on DailyMed (effective November 29, 2025, EPIC PHARMA, LLC); the selegiline FDA label on DailyMed (effective August 7, 2024, Rising Pharma Holdings, Inc.).
What does the meperidine label say about selegiline?
Meperidine's label does not name selegiline itself; it warns about its class (MAO inhibitors):
Meperidine label, boxed warningConcomitant use of Meperidine Hydrochloride Tablets with Monoamine Oxidase Inhibitors (MAOIs) Concomitant use of meperidine hydrochloride tablets with monoamine oxidase inhibitors (MAOIs) can result in coma, severe respiratory depression, cyanosis, and hypotension.
Meperidine label, boxed warningUse of meperidine hydrochloride tablets with MAOIs within last 14 days is contraindicated [see Contraindications (4), Warnings and Precautions (5.8), Drug Interactions (7) ].
Source: FDA drug label (Meperidine Hydrochloride), EPIC PHARMA, LLC, effective November 29, 2025 (SPL set fae5cc34-5917-4445-9516-25f97ffca8db), via openFDA; the full label on DailyMed
What does the selegiline label say about meperidine?
Selegiline label, contraindicationsSelegiline is contraindicated for use with meperidine (DEMEROL & other trade names).
Selegiline label, drug interactionsDRUG INTERACTIONS The occurrence of stupor, muscular rigidity, severe agitation, and elevated temperature has been reported in some patients receiving the combination of selegiline and meperidine.
Zelapar label (Bausch Health US, LLC, June 1, 2021), contraindicationsCONTRAINDICATIONS ZELAPAR is contraindicated in patients with: Concomitant use of opioid drugs (e.g., meperidine, tramadol, or methadone).
Zelapar label (Bausch Health US, LLC, June 1, 2021), drug interactionsDRUG INTERACTIONS 7.1 Opioid Drugs Because serious, sometimes fatal reactions have been precipitated with concomitant use of opioid drugs (e.g., meperidine and its derivatives, methadone, or tramadol) and MAOIs, including selective MAO-B inhibitors, concomitant use of these drugs with ZELAPAR is contraindicated [see Contraindications ( 4 ) and Warnings and Precautions ( 5.2 )].
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 (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
| Meperidine | Selegiline | |
|---|---|---|
| Labeled for | Pain | Parkinson's disease, Depression |
| Boxed warning | Yes | No |
| Pharmacy cost (NADAC) | $0.157 per mL 50 mg/5 mL solution | $0.756 per capsule 5 mg capsule |
| Shortage now | Listed; available | 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