Do not consume large amounts of tyramine-containing foods when taking which medication?

• A. Ropinirole
• B. Entacapone
• C. Benztropine
• D. Selegiline

Answer: (D)

The key concept is that certain medications inhibit monoamine oxidase (MAO), which normally helps break down tyramine. When tyramine-rich foods are eaten while MAO is inhibited, tyramine can enter the bloodstream and trigger a large release of norepinephrine, potentially causing a dangerous hypertension crisis. Selegiline is a monoamine oxidase B inhibitor used in Parkinson disease; by blocking MAO, it raises the risk that tyramine will cause a spike in blood pressure if large amounts of tyramine-containing foods are consumed. That’s why avoiding these foods is advised with this medication.

Ropinirole is a dopamine agonist, not one that inhibits MAO. Entacapone inhibits COMT, which affects L-DOPA breakdown but doesn’t cause tyramine interactions. Benztropine is an anticholinergic and has no tyramine interaction.