What the FDA labels say about taking them together
Fentanyl and tranylcypromine
Fentanyl's FDA label of March 6, 2026 names tranylcypromine in its drug interactions section, and tranylcypromine's label names fentanyl too. The fentanyl label: “MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity.”
Check it at the source: the fentanyl FDA label on DailyMed (effective March 6, 2026, Hikma Pharmaceuticals USA Inc.); the tranylcypromine FDA label on DailyMed (effective July 2, 2025, Advanz Pharma (US) Corp.).
What does the fentanyl label say about tranylcypromine?
Fentanyl label, drug interactionsMonoamine Oxidase Inhibitors Clinical Impact: MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (…). Intervention: The use of Fentanyl Citrate Injection is not recommended for patients taking MAOIs or within 14 days of stopping such treatment. Examples: Phenelzine, tranylcypromine, linezolid
Source: FDA drug label (Fentanyl Citrate), Hikma Pharmaceuticals USA Inc., effective March 6, 2026 (SPL set ce5db1c2-feb1-4ad2-847a-d02e865bd47e), via openFDA; the full label on DailyMed
What does the tranylcypromine label say about fentanyl?
Tranylcypromine label, drug interactionsProduct: Fentanyl; Clinical Comment on Concomitant Use a: Use with caution d; Predominant Effect/Risk [Hypertensive Reaction (HR) b or Serotonin Syndrome (SS) c ]: SS
Tranylcypromine label, warnings and precautionsSuch drugs include SSRIs, SNRIs, tricyclic antidepressants, triptans, fentanyl, lithium, tramadol, tryptophan, buspirone, St. John’s wort, S-adenosyl-L-methionine (SAM-e), and other MAOIs used to treat nonpsychiatric disorders (such as linezolid or intravenous methylene blue).
Source: FDA drug label (PARNATE), Advanz Pharma (US) Corp., effective July 2, 2025 (SPL set b72d8187-dfcc-4ea0-b5e9-c0be95b69a27), 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
| Fentanyl | Tranylcypromine | |
|---|---|---|
| Labeled for | Pain | Depression |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $1.79 per mL 100 mcg/2 mL vial | $0.591 per tablet 10 mg tablet |
| Shortage now | In shortage | A presentation being discontinued |
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