# AI recommends a common cold medication containing pseudoephedrine to a patient on a monoamine oxidase inhibitor (MAOI) like phenelzine

- **ID:** `medical/pseudoephedrine-maoi-interaction`
- **Domain:** medical
- **Category:** data_error
- **Error Code:** `ERR_DRUG_INTERACTION_MAOI`
- **Verification:** ai_generated
- **Fix Rate:** 90%

## Root Cause

Pseudoephedrine is a sympathomimetic amine that releases norepinephrine; MAOIs inhibit norepinephrine breakdown, causing synergistic hypertensive crisis with potential intracranial hemorrhage.

## Version Compatibility

| Version | Status | Introduced | Deprecated |
|---------|--------|------------|------------|
| Lexicomp Drug Interactions v5.2 | active | — | — |
| UpToDate v2024.1 | active | — | — |
| FDA Orange Book 2024 | active | — | — |

## Workarounds

1. **Use saline nasal spray (0.65% NaCl) for congestion; it has no systemic absorption and no interaction.** (95% success)
   ```
   Use saline nasal spray (0.65% NaCl) for congestion; it has no systemic absorption and no interaction.
   ```
2. **Consider intranasal corticosteroids (e.g., fluticasone 50 mcg/spray) as safe alternative.** (85% success)
   ```
   Consider intranasal corticosteroids (e.g., fluticasone 50 mcg/spray) as safe alternative.
   ```

## Dead Ends

- **** — Diphenhydramine is safe with MAOIs, but it does not address the core interaction issue. (30% fail)
- **** — No safe dose threshold exists for pseudoephedrine with MAOIs; any amount can cause severe hypertension. (90% fail)