Risk of serotonin syndrome w/ irreversible non-selective MAOIs; irreversible MAO-B inhibitors (eg, selegiline or rasagiline); serotonergic medicinal products (eg, tramadol, sumatriptan & other triptans); St. John's wort. May lower seizure threshold w/ antidepressants (TCAs, SSRIs, SNRIs) & neuroleptics (phenothiazines, thioxanthenes & butyrophenones), mefloquin, buproprion, tramadol. Increased exposure w/ strong inhibitors of CYP3A4 (eg, itraconazole, voriconazole, clarithromycin, telithromycin, nefazodone, conivaptan & HIV PIs) & CYP2C9 inhibitors (eg, fluconazole & amiodarone). Decreased AUC w/ rifampicin, carbamazepine, phenytoin. Increased risk of bleeding w/ oral anticoagulants or antiplatelet medicinal products. Enhanced effects w/ lithium or tryptophan. Moclobemide; linezolid; strong CYP2D6 inhibitors (eg, bupropion, quinidine, fluoxetine, paroxetine).
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