Dextromethorphan
http://www.tga.gov.au/npmeds/pi-dextromethorphan.rtf
Australian Government Department of Health and Ageing.
Therapeutic Goods Administration
Dextromethorphan:
Serotonin Syndrome and other drug drug interactions -
Quote:
Interaction with other medicines
The following interactions with dextromethorphan have been noted:
Dextromethorphan should not be used in patients taking monoamine oxidase inhibitors (MAOIs) or who have taken MAOIs within the previous 14 days. The use of dextromethorphan with, or within two weeks of taking MAOIs, may increase the risk of serious side effects such as hypertensive crisis, hyperpyrexia and convulsions.
Dextromethorphan when used with SSRI’s (such as fluoxetine) or tricyclic antidepressants (such as clomipramine and imipramine) may result in a "serotonin syndrome” with changes in mental status, hypertension, restlessness, myoclonus, hyperreflexia, diaphoresis, shivering and tremor.
Serum levels of dextromethorphan may be increased by the concomitant use of inhibitors of cytochrome P450 2D6, such as the antiarrhythmics quinidine and amiodarone, antidepressants such as fluoxetine and paroxetine, or other drugs which inhibit cytochrome P450 2D6 such as haloperidol and thioridazine.
Concomitant use of dextromethorphan and other CNS depressants (e.g. alcohol, narcotic analgesics and tranquillizers) may increase the CNS depressant effects of these drugs.
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