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Table 4. Tyramine-Containing Foodsa
Class of Food and Beverage
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Tyramine-Rich Foods and Beverages To Avoid
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Acceptable Foods Containing Little or No Tyramine
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Meat, poultry, and fish |
Air-dried, aged, and fermented meats, sausages, and salamis (including cacciatore, hard salami, and mortadella); pickled herring; and any spoiled or improperly stored meat, poultry, and fish (e.g., foods that have undergone changes in color or odor or that have become moldy); spoiled or improperly stored animal livers |
Fresh meat, poultry, and fish, including fresh processed meats (e.g., lunch meats, hot dogs, breakfast sausage, and cooked sliced ham) |
Vegetables |
Broad bean pods (fava bean pods) |
All other vegetables |
Dairy |
Aged cheeses |
Processed cheeses, mozzarella, ricotta cheese, cottage cheese, and yogurt |
Beverages |
All varieties of tap beer, and beers that have not been pasteurized so as to allow for ongoing fermentation |
As with other antidepressants, concomitant use of alcohol with selegiline is not recommended. (Bottled and canned beers and wines contain little or no tyramine.) |
Miscellaneous |
Concentrated yeast extract (e.g., Marmite), sauerkraut, most soybean products (including soy sauce and tofu); OTC supplements containing tyramine |
Brewer’s yeast, baker’s yeast, soy milk, commercial chain-restaurant pizzas prepared with cheeses low in tyramine |
OTC = over-the-counter.
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aAdapted from the EMSAM Medication Guide.[44] The foods and beverages listed above should be avoided beginning on the first day of treatment with selegiline 9 mg/24 h or 12 mg/24 h and should continue to be avoided for 2 weeks after a dose reduction to 6 mg/24 h or following the discontinuation of selegiline 9 mg/24 h or 12 mg/24 h.
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References
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Medication Guide: EMSAM. Princeton, NJ: Bristol-Myers Squibb Company, 2006. Available online. Last accessed April 10, 2009.
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