skip to main content

MAOI Dental Interactions — MFDS Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

HardPharmacologyMAOI Dental InteractionsMFDS Part 1

A patient taking tranylcypromine is undergoing a dental extraction in a specialist conscious-sedation service. Which proposed medicine is contraindicated because its interaction with the monoamine oxidase inhibitor may cause a severe hypertensive reaction?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Ephedrine administered for procedure-related hypotension

Ephedrine is an indirectly acting sympathomimetic that releases stored noradrenaline. Tranylcypromine prevents monoamine breakdown, so this combination can produce an excessive catecholamine response and severe hypertension; the UK SmPC therefore contraindicates it. The principal distractor is adrenaline-containing dental local anaesthetic. Although older sources described this as hazardous, current NHS specialist advice considers a clinically significant interaction unlikely when a licensed dental dose is administered correctly; however, the product-specific SmPC must be checked because some formulations retain an MAOI contraindication. Felypressin-containing local anaesthetic has no clinically significant MAOI interaction when used as licensed. Amoxicillin and paracetamol do not have the relevant sympathomimetic interaction.

Reference: electronic Medicines Compendium. Tranylcypromine 10 mg Film-Coated Tablets, Summary of Product Characteristics, sections 4.3 and 4.5. Updated 6 March 2026. https://www.medicines.org.uk/emc/product/101958/smpc