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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by ChicagoKat on October 10, 2012, at 15:46:35
I'm on Nardil, and I have two questions regarding drug interactions with it, and hope some of you experts can help out.
1. Are there any known antihypertensive interactions with MAOIs? I couldn't find any in my references, but I thought I'd double-check with the resident experts. I do have endongenous HTN, and, unfortunately, the famous MAOI hypotension has not kicked in; in fact, it has actually worsened, probably b/c I'm on a TCA too. And, I'll be honest, b/c I just can't kick my smoking habit...though I've cut down a lot!!! I'm seeing my PCP soon, and I want to be sure anything new we might try would be OK. Right now I'm on quinapril, metoprolol, and occasionally, amlodipine.
2. Kinda a strange question, but I just LOVE diet coke. And, while checking my references, under phenelzine it listed both tyrosine and phenylalanine as substances to avoid. The aspartame that's in diet coke is a small peptide containing tyrosine and phenylalanine! So, do you think it's possible my beloved diet coke is contributing to my HTN problems??
Thanks in advance for any responses,
Kat
Posted by SLS on October 10, 2012, at 16:40:10
In reply to MAOI interactions questions, posted by ChicagoKat on October 10, 2012, at 15:46:35
You might be right about the TCA. Interestingly, nortriptyline can produce a dilation of peripheral blood vessels via NE alpha-1 receptor blockade. You could look into using clonidine if your HTN remains refractory to other treatments.
What is your BP?
- Scott
Posted by ChicagoKat on October 10, 2012, at 16:49:19
In reply to Re: MAOI interactions questions » ChicagoKat, posted by SLS on October 10, 2012, at 16:40:10
> You might be right about the TCA. Interestingly, nortriptyline can produce a dilation of peripheral blood vessels via NE alpha-1 receptor blockade. You could look into using clonidine if your HTN remains refractory to other treatments.
>
> What is your BP?
>
>
> - ScottMy BP has been running at about 150/90-100 *without* antihypertensives. I get it back into the normal range with the antihypertensives, but it seems to be stubborn, and takes more of them than it used to. btw Scott, you should know, I just had to switch back to elavil from Nortryptiline so that I could sleep. I'm only taking 25-50mg qhs. Clonodine and prazosin are 2 of the drugs I was gonna ask my pcp about when I see her next week, as long as they are safe with Nardil
And interestingly, I've found info that says that aspartame,and thus my beloved diet cokes, should indeed be avoided by people on MAOIs. I was NEVER told this, and I'm pretty sure my pdoc knows about my love of diet coke, but I'm not sure. I'm crushed, if it is indeed true. I could more easily give up smoking than I could diet coke :(
Posted by emmanuel98 on October 10, 2012, at 18:50:44
In reply to Re: MAOI interactions questions » SLS, posted by ChicagoKat on October 10, 2012, at 16:49:19
A while back, someone sent a link to an excellent article on MAOI and food/drink interactions. People tend to worry a lot more than necessary about this. You'd probably need to drink a gallon of diet coke to react with the nardil, just like you need to eat 3-4 oz of cheese to (maybe) cause an adverse reaction. If these were so dangerous that you couldn't have a couple of diet cokes or a little parmesan on your spaghetti, no one would ever prescribe them. Certainly not to someone like me who has been suicidal.
Posted by SLS on October 10, 2012, at 19:23:30
In reply to Re: MAOI interactions questions » SLS, posted by ChicagoKat on October 10, 2012, at 16:49:19
Amitriptyline blocks NE alpha-1 receptors, too.
> And interestingly, I've found info that says that aspartame,and thus my beloved diet cokes, should indeed be avoided by people on MAOIs. I was NEVER told this, and I'm pretty sure my pdoc knows about my love of diet coke, but I'm not sure. I'm crushed, if it is indeed true. I could more easily give up smoking than I could diet coke :(
I drink quite a bit of Diet Coke. I never had a reaction while on Nardil or Parnate.
- Scott
Posted by ChicagoKat on October 10, 2012, at 19:40:41
In reply to Re: MAOI interactions questions, posted by emmanuel98 on October 10, 2012, at 18:50:44
> A while back, someone sent a link to an excellent article on MAOI and food/drink interactions. People tend to worry a lot more than necessary about this. You'd probably need to drink a gallon of diet coke to react with the nardil, just like you need to eat 3-4 oz of cheese to (maybe) cause an adverse reaction. If these were so dangerous that you couldn't have a couple of diet cokes or a little parmesan on your spaghetti, no one would ever prescribe them. Certainly not to someone like me who has been suicidal.
Thanks for the info emmanuel. Problem is, I probably do drink about a gallon of diet coke a day. Tomorrow I'm gonna try cutting back to just having one large one in the am like I always do, cos that's when I need it the most. For the rest of the day I'll try Coke Zero which is the yuck to me, but maybe with time I'll come to like it ok. We'll see if that helps.
Kat
Posted by ChicagoKat on October 10, 2012, at 19:42:16
In reply to Re: MAOI interactions questions » ChicagoKat, posted by SLS on October 10, 2012, at 19:23:30
> Amitriptyline blocks NE alpha-1 receptors, too.
>
> > And interestingly, I've found info that says that aspartame,and thus my beloved diet cokes, should indeed be avoided by people on MAOIs. I was NEVER told this, and I'm pretty sure my pdoc knows about my love of diet coke, but I'm not sure. I'm crushed, if it is indeed true. I could more easily give up smoking than I could diet coke :(
>
> I drink quite a bit of Diet Coke. I never had a reaction while on Nardil or Parnate.
>
>
> - ScottGood to know. Maybe I'll not have to give up my lovely diet coke after all
Kat
Posted by phillipa on October 11, 2012, at 11:04:17
In reply to Re: MAOI interactions questions » SLS, posted by ChicagoKat on October 10, 2012, at 19:42:16
No soda will eat your teeth. Water, green iced tea. Phillipa
Posted by ChicagoKat on October 11, 2012, at 12:15:50
In reply to Re: MAOI interactions questions » ChicagoKat, posted by phillipa on October 11, 2012, at 11:04:17
> No soda will eat your teeth. Water, green iced tea. Phillipa
Well, at least the soda I love has no sugar in it, so I'm not as worried about my teeth, as I am now worried about my BP. Oh, and orange Gatorade FTW :D
Kat
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