Azilect Interactions: Alcohol, Medications, and Others

Does Azilect interact with other drugs?

Before you start taking Azilect, tell your doctor and pharmacist about any prescription, over-the-counter (OTC), or other drugs you take. Sharing this information with them may help prevent possible interactions.

To learn whether Azilect interacts with herbs, vitamins, or supplements, see the “Are there other interactions with Azilect?” section.

The following table lists drugs that may interact with Azilect. Keep in mind that this table does not include all drugs that may interact with Azilect. For more information about some of these interactions, see the “Drug interactions explained” section.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

When should I avoid Azilect?

Certain health conditions or other factors could raise your risk of harm if you take Azilect. In such cases, your doctor may not prescribe Azilect for you. These are known as contraindications. Azilect has several contraindications, as follows.

If you take meperidine, tramadol, methadone, or propoxyphene: Your doctor won’t prescribe Azilect if you’re also prescribed certain opioid pain relievers. These include meperidine, tramadol, methadone, or propoxyphene. This is because of the risk of serotonin syndrome when these medications are taken together. This side effect results from high levels of serotonin (a chemical in your brain).

Symptoms of serotonin syndrome may include:

• nausea or diarrhea
• sweating
• inability to get refreshing sleep (insomnia)
• confusion
• experiences that seem real but are not (hallucinations)
• coma
• fever
• high blood pressure or increased heart rate
• tremor

Serotonin syndrome may be life threatening or fatal. Due to this risk, your doctor will likely wait 14 days after you stop Azilect to start one of these medications.

If you take other monoamine oxidase inhibitors (MAOIs): Azilect is an MAOI. Taking other MAOIs such as phenelzine or selegiline with Azilect may increase the risk of your blood pressure rising rapidly. This may need immediate medical care. Taking these medications together may also increase your risk of developing serotonin syndrome.

Due to these risks, your doctor will likely wait 14 days after stopping Azilect to begin treatment with another MAOI. This is to make sure Azilect is cleared from your body.

If you take St. John’s wort: St. John’s wort is a supplement that has effects similar to antidepressant drugs. Taking certain antidepressants with Azilect may increase your risk of serotonin syndrome.

Due to this risk, your doctor may inquire whether you’re taking supplements or OTC medications before prescribing Azilect.

If you take cyclobenzaprine: Taking Azilect with cyclobenzaprine may increase your risk of serotonin syndrome.

Azilect may also make you feel sleepier than usual. Taking cyclobenzaprine with Azilect may make this side effect worse.

Due to this risk, your doctor may suggest a different medication instead of cyclobenzaprine.

If you take dextromethorphan: Taking Azilect with dextromethorphan can increase your risk of psychosis (impaired reality) or unusual behavior.

Your doctor can discuss this in more detail with you.

If you’ve had an allergic reaction: If you’ve ever had an allergic reaction to Azilect or any of its ingredients, your doctor likely won’t prescribe Azilect for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start taking Azilect, talk with your doctor if any of the factors mentioned here apply to you. Your doctor can determine whether Azilect is safe for you to take.

Does Azilect interact with alcohol?

Certain types of beer and wine contain a substance called tyramine. Ingesting high amounts of tyramine during Azilect treatment may affect your blood pressure. It could cause a fast or marked increase in your blood pressure, which could be dangerous.

Azilect and alcohol also cause some similar side effects, such as sleepiness. If you drink alcohol during your Azilect treatment, you may be more likely to have this side effect.

If you have questions about consuming alcohol during Azilect treatment, talk with your doctor or pharmacist.

Drug interactions explained

Interaction with certain drugs that mimic the sympathetic nervous system

Certain drugs that mimic the sympathetic nervous system can increase the risk of your blood pressure rising rapidly. If this happens, you may need immediate medical care to avoid serious events such as stroke or heart attack. Your sympathetic nervous system is known as your “fight or flight” response. This means it’s responsible for increases in heart rate and breathing rate in response to stressors.

Drugs that mimic the sympathetic nervous system may be prescribed for multiple conditions. They may be available in different forms, such as drops or oral pills.

Some drugs that mimic the sympathetic nervous system and may interact with Azilect are:

• brimonidine (Mirvaso, Alphagan P, Qoliana, Lumify)
• pseudoephedrine (Sudafed 24 Hour)
• ephedrine (Rezipres, Akovaz, Corphedra, Emerphed)

What you can do

If you take Azilect along with a drug that mimics the sympathetic nervous system, watch for symptoms of high blood pressure. If you have any, tell your doctor right away. These symptoms include:

• shortness of breath
• confusion
• chest pain

If you have questions about these drugs together, talk with your doctor or pharmacist.

Interaction with certain antidepressant drugs

Taking certain antidepressant drugs with Azilect may increase the risk of serotonin syndrome. Serotonin syndrome is a serious side effect resulting from high levels of serotonin (a chemical in your brain). It could be life threatening or fatal. Symptoms of serotonin syndrome may include:

• nausea or diarrhea
• sweating
• inability to get refreshing sleep (insomnia)
• confusion
• experiences that seem real but are not (hallucinations)
• coma
• fever
• high blood pressure or increased heart rate
• tremor

Some antidepressant drugs that may interact with Azilect are:

• sertraline (Zoloft)
• duloxetine (Cymbalta, Drizalma Sprinkle)
• amitriptyline
• trazodone
• mirtazapine (Remeron)

What you can do

Due to the risk of serotonin syndrome, tell your doctor if you take other antidepressant drugs before starting Azilect. They will likely recommend that your current antidepressant and Azilect not be taken together.

You and your doctor may decide to stop Azilect so that you can start treatment with an antidepressant drug. If so, you’ll need to stop Azilect for 14 days before starting the antidepressant drug. Before starting certain antidepressant drugs, you may need to wait more than 14 days after stopping Azilect.

If you have questions about taking Azilect with antidepressant drugs, talk with your doctor or pharmacist.

Interaction with certain drugs that slow the CYP1A2 enzyme (a protein) in the body

CYP1A2 is an enzyme in the liver that helps break down certain drugs, including Azilect. Taking certain drugs that slow this enzyme during Azilect treatment may cause a buildup of Azilect. In fact, it can double the amount of Azilect in your body. Higher amounts of Azilect in the body may increase your risk of side effects.

Drugs that slow the CYP1A2 enzyme and may interact with Azilect include:

• ciprofloxacin (Cipro, Ciloxan, Cetraxal)
• fluvoxamine (Luvox)

Note: Fluvoxamine is also used as an antidepressant drug. See the “Interaction with certain antidepressant drugs” section to learn more.

What you can do

If you take Azilect with a drug that slows the CYP1A2 enzyme, your doctor may prescribe a lower dosage of Azilect. You should not take a dose of either medication that’s higher than what your doctor prescribes.

If you have questions about taking Azilect with drugs that slow the CYP1A2 enzyme, talk with your doctor or pharmacist.

Are there other interactions with Azilect?

Azilect may have other interactions. They could occur with supplements or foods.

The interactions discussed below aren’t all those possible with Azilect.

Does Azilect interact with supplements?

Before you start taking Azilect, talk with your doctor and pharmacist about any herbs, vitamins, or supplements you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Azilect interactions with herbs

Azilect can interact with St. John’s wort, which is taken to help treat depression. St. John’s wort may also be taken to help treat attention deficit hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD). It’s also taken to help treat other conditions.

Azilect interactions with vitamins

Azilect currently has no reports of interacting with vitamins. But this doesn’t mean that interactions with vitamins won’t be recognized in the future.

For this reason, it’s important to check with your doctor or pharmacist before taking any of these products while taking Azilect.

Does Azilect interact with food?

Taking Azilect and consuming foods high in tyramine may cause your blood pressure to rise quickly and severely. The following foods are high in tyramine:

• aged cheeses
• aged and fermented meats
• fava bean pods
• sauerkraut
• most soybean products
• certain beers and wines

Due to this risk, your doctor may recommend that you avoid foods that contain high amounts of tyramine during Azilect treatment. If you consume high amounts of tyramine and then don’t feel well, tell your doctor immediately.

Does Azilect interact with vaccines?

Azilect currently has no reports of interacting with vaccines. If you have questions about getting certain vaccines during your Azilect treatment, talk with your doctor.

Does Azilect interact with lab tests?

Azilect currently has no reports of interacting with lab tests. If you have questions about having certain lab tests during your treatment with Azilect, talk with the healthcare professional ordering the test.

Does Azilect interact with cannabis or CBD?

Azilect currently has no reports of interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Azilect.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Does my health history affect whether I should take Azilect?

Certain medical conditions or other health factors may raise the risk of interactions with Azilect. Before taking Azilect, talk with your doctor about your health history. They’ll determine whether Azilect is right for you.

Health conditions or other factors that might interact with Azilect include:

Certain heart conditions: Taking Azilect may worsen certain heart conditions, such as high blood pressure. The medications you take to manage your blood pressure may need to be adjusted once you start Azilect. You should also avoid foods high in tyramine while taking Azilect, as this could also increase your risk of dangerous blood pressure increases. See the “Does Azilect interact with food?” section to learn more.

Taking Azilect also may worsen orthostatic hypotension. With this, you experience a sudden drop in blood pressure when moving from sitting to standing. It’s most common within the first 2 months of treatment with Azilect.

Talk with your doctor. Learn how to keep your blood pressure in a range that’s right for you during treatment with Azilect.

Mental health problems: If you have certain mental health problems, taking Azilect may worsen these conditions. Or they may make the drug less effective. These problems include major psychotic disorders.

If you have a sleeping disorder, take certain sleep medications, or both, Azilect may worsen somnolence (feeling very sleepy). This could be particularly dangerous if you feel sleepy while driving or operating heavy machinery. If you find you’re drowsy during the day while taking Azilect, your doctor may choose to stop the drug. Based on reports, taking a lower dose may not reduce this risk.

Your mental health or behavior may decline severely after starting Azilect or a dosage increase. For example, you may have experiences that seem real but are not (hallucinations) during Azilect treatment. Or you might have psychosis (impaired reality) during Azilect treatment. If this happens, tell your doctor right away. They may choose to stop Azilect or reduce your dose.

Taking Azilect may lower your defenses against compulsive behaviors. These include gambling, binge eating, or spending money. If you develop these behaviors, your doctor may stop Azilect or reduce your dose.

Use of certain antidepressant drugs with Azilect can also increase your risk of serotonin syndrome. (See the “Interaction with certain antidepressant drugs” section to learn more.)

Liver problems: If you have mild liver problems, you’ll likely be prescribed a lower dose of Azilect. But if you have moderate or severe liver problems, you’ll likely be prescribed a different drug.

Pregnancy: It’s not known whether Azilect is safe to take during pregnancy. If you’re pregnant or may become pregnant, talk with your doctor before taking Azilect.

Breastfeeding: It’s not known whether it’s safe to take Azilect while breastfeeding. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.

Allergic reaction: If you’ve ever had an allergic reaction to Azilect or any of its ingredients, your doctor likely won’t prescribe Azilect. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better for you.

How can I prevent interactions?

Taking certain steps can help you avoid interactions with Azilect. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• whether you drink alcohol or use cannabis
• the list of medications you take, as well as any vitamins, supplements, and herbs
• what to do if you start taking a new drug during your Azilect treatment

It’s also important to understand Azilect’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. The paperwork, sometimes called the patient package insert or medication guide, may have other details about interactions.

If you did not get paperwork with Azilect, ask your pharmacist to print a copy for you. If you have difficulty reading or understanding this information, your doctor or pharmacist can help.

Taking Azilect exactly as prescribed also can help prevent interactions.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.