When you take a MAO inhibitor, a type of antidepressant that blocks the enzyme monoamine oxidase to regulate mood chemicals in the brain. Also known as monoamine oxidase inhibitors, these drugs are used for depression and anxiety when other treatments fail. But they come with a strict rule: avoid certain foods. Eating the wrong thing while on an MAO inhibitor can spike your blood pressure to dangerous levels—sometimes fast enough to land you in the ER.
The problem isn’t the drug itself, it’s tyramine, a naturally occurring compound found in aged, fermented, or spoiled foods that can trigger a hypertensive crisis when MAO is blocked. Normally, your body breaks down tyramine with the help of monoamine oxidase. But when that enzyme is turned off by drugs like Emsam, a selegiline patch used for depression that requires dietary caution. or phenelzine, tyramine builds up and forces your body to release too much norepinephrine. That’s what sends your blood pressure soaring.
You don’t need to starve yourself, but you do need to know what’s risky. Hard cheeses like parmesan, blue cheese, and aged cheddar are big ones. Cured meats—salami, pepperoni, summer sausage—carry tyramine from fermentation. Tap beer, red wine, and fermented soy products like miso and soy sauce can also trigger reactions. Even leftovers sitting past their prime can become dangerous. Some people think only old-school MAO inhibitors like Nardil require this, but even the patch form, Emsam, has warnings at higher doses. The lowest patch dose (6 mg) may be safer for some foods, but it’s not risk-free.
This isn’t theoretical. Real patients have ended up in the hospital after eating a slice of aged cheese with dinner while on selegiline. Others didn’t realize their homemade sauerkraut or overripe banana was the problem. It’s not about being perfect—it’s about being aware. If you’re on an MAO inhibitor, your pharmacist should give you a list. If they don’t, ask. Keep it on your fridge. Show it to your family. This isn’t just a medical rule—it’s a safety habit.
The posts below cover what you need to know beyond the basics. You’ll find real comparisons between antidepressants like Emsam and other options, tips for managing side effects, and how genetics can change how your body handles these drugs. Some posts even dig into how diet affects medication safety beyond just tyramine—like how sugar or vitamins interact with what you’re taking. Whether you’re new to MAO inhibitors or have been on them for years, these guides help you make smarter choices every day.
Linezolid can cause dangerous hypertensive reactions when mixed with tyramine-rich foods like aged cheese, red wine, or cured meats. Learn what to avoid, how long to follow the diet, and what to do if you accidentally eat something risky.
