Selected Antidiabetics/MAOIs Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

The cause of the interaction is not known. When these two medicines are taken together, your body may produce more insulin than expected. Your body may not respond properly to low blood sugar levels.

What might happen:

Your blood sugar levels may decrease and cause harmful effects.

What you should do about this interaction:

If you experience a sudden onset of cold sweat, dizziness, fatigue, shakiness, rapid heartbeat, nausea, vision changes, confusion, personality change, nervousness, or hunger, contact your doctor. It may be necessary to measure your blood sugar levels more often. Your doctor may need to adjust the dose of your diabetes medicine. The full effects of this interaction may take several weeks to appear and may last for several weeks after you stop taking your other medicine.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Cooper AJ, Keddie KMG. Hypotensive collapse and hypoglycaemia after mebanazine -- a monoamine-oxidase inhibitor. Lancet 1964 May 23;1:1133-5.
  • 2.Cooper AJ, Ashcroft G. Potentiation of insulin hypoglycaemia by M.A.O.I. antidepressant drugs. Lancet 1966 Feb 19;1(7434):407-9.
  • 3.Cooper AJ. The action of mebanazine, a mono amine oxidase inhibitor antidepressant drug in diabetes. II. Int J Neuropsychiatry 1966 Aug; 2(4):342-5.
  • 4.Cooper AJ, Ashcroft G. Modification of insulin and sulfonylurea hypoglycemia by monoamine- oxidase inhibitor drugs. Diabetes 1967 Apr; 16(4):272-4.
  • 5.Adnitt PI. Hypoglycemic action of monoamineoxidase inhibitors (MAOI'S). Diabetes 1968 Oct;17(10):628-33.
  • 6.Absher JR, Black DW. Tranylcypromine withdrawal delirium. J Clin Psychopharmacol 1988 Oct;8(5):379-80.
  • 7.Ramsay RR, Dunford C, Gillman PK. Methylene blue and serotonin toxicity: inhibition of monoamine oxidase A (MAO A) confirms a theoretical prediction. Br J Pharmacol 2007 Nov;152(6):946-51.
  • 8.Peter C, Hongwan D, Kupfer A, Lauterburg BH. Pharmacokinetics and organ distribution of intravenous and oral methylene blue. Eur J Clin Pharmacol 2000 Jun;56(3):247-50.
  • 9.Aleyassine H, Gardiner RJ. Dual action of antidepressant drugs (MAO inhibitors) on insulin release. Endocrinology 1975 Mar;96(3):702-10.
  • 10.Aleyassine H, Lee SH. Inhibition of insulin release by substrates and inhibitors of monoamine oxidase. Am J Physiol 1972 Mar;222(3):565-9.
  • 11.Aleyassine H, Lee SH. Inhibition by hydrazine, phenelzine and pargyline of insulin release from rat pancreas. Endocrinology 1971 Jul;89(1):125-9.
  • 12.Surmaitis RM, Nappe TM, Cook MD. Serotonin syndrome associated with therapeutic metaxalone in a patient with cirrhosis. Am J Emerg Med 2016 Feb;34(2):346.e5-6.
  • 13.Skelaxin (metaxalone) US prescribing information. Pfizer Laboratories Div Pfizer Inc. January, 2024.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.