What foods should I avoid while taking MAOIs?

October 13, 2025 •

4 min read

Monoamine oxidase inhibitors (MAOIs) block an enzyme that normally breaks down tyramine, an amino acid found in certain foods. This can lead to a dangerous buildup of tyramine in the body, which is why understanding what foods should I avoid while taking MAOIs? is critical for patient safety.

Quick Summary

Taking MAOIs requires avoiding foods high in tyramine to prevent a severe blood pressure spike. These include aged cheeses, cured meats, and fermented products. Strict adherence to a low-tyramine diet is crucial for safety during treatment and for several weeks after stopping the medication.

Key Points

High-Tyramine Foods: Aged cheeses, cured meats, and fermented items like sauerkraut, soy sauce, and yeast extracts must be avoided.
Hypertensive Crisis Risk: Eating tyramine-rich foods with MAOIs can cause a dangerous spike in blood pressure, a medical emergency known as a hypertensive crisis.
Prioritize Freshness: Tyramine levels increase with food aging and spoilage; therefore, always consume the freshest possible foods and avoid leftovers.
Dietary Duration: The low-tyramine diet must be followed while taking the MAOI and for several weeks after stopping the medication.
Symptom Recognition: Know the signs of a hypertensive crisis, including severe headache and stiff neck, and seek immediate medical attention if they occur.
Consult a Professional: Always talk to your healthcare provider or a dietitian for personalized dietary advice while on MAOIs, as individual sensitivity can differ.

The Crucial Link Between MAOIs and Tyramine

Monoamine oxidase inhibitors, or MAOIs, are a class of medication used to treat conditions such as depression and Parkinson's disease. They work by blocking the enzyme monoamine oxidase (MAO), which is responsible for breaking down neurotransmitters and other compounds, including tyramine. When this enzyme is inhibited, tyramine from food is not properly metabolized and can accumulate to dangerous levels in the body. This can trigger a sudden and severe spike in blood pressure, known as a hypertensive crisis, which can be a medical emergency and lead to complications like stroke or heart attack.

Therefore, anyone prescribed an MAOI must follow a strict, low-tyramine diet. This dietary restriction is not only necessary while actively taking the medication but also for at least two to four weeks after discontinuing it, as the enzyme's activity takes time to return to normal.

High-Tyramine Foods to Strictly Avoid

To prevent a dangerous reaction, it is essential to eliminate foods with high tyramine content from your diet. Pay close attention to items that are aged, cured, fermented, or spoiled, as these processes significantly increase tyramine levels.

Aged and Cured Cheeses: Any cheese that has been aged is a major source of tyramine. This includes aged cheddar, Swiss, Parmesan, blue cheeses (e.g., Stilton, Gorgonzola), feta, and Camembert.
Cured, Smoked, and Processed Meats: Tyramine levels are high in meats that have been treated with salt and nitrates. Items to avoid include dry-type summer sausage, salami, pepperoni, bacon, and cured or smoked fish.
Fermented and Pickled Products: The fermentation process creates significant amounts of tyramine. Avoid sauerkraut, kimchi, pickled fish, kefir, and kombucha. Fermented soy products like miso, tempeh, and certain types of tofu are also on the restricted list.
Yeast Extracts: Savory spreads like Marmite and Vegemite, as well as products made with brewer's yeast, contain high concentrations of tyramine. Sourdough bread may also have higher levels.
Certain Fruits and Vegetables: While most fruits and vegetables are safe, a few contain higher tyramine. These include fava beans (broad beans), snow peas, overripe fruits, and dried fruits like raisins.
Fermented Sauces: Many popular sauces and condiments contain high levels of tyramine. Examples include soy sauce, fish sauce, teriyaki sauce, and some concentrated meat or yeast-based bouillon cubes.
Alcoholic Beverages: Different types of alcohol carry varying risks, but it is safest to avoid them altogether. High-tyramine alcoholic beverages include tap or home-brewed beer, red wines (especially Chianti and vermouth), and fortified wines like sherry.

Managing Your Diet: A Comparison of Food Choices

Navigating a low-tyramine diet can seem daunting, but many delicious and safe options exist. Focusing on fresh, minimally processed foods is the best strategy. The following table provides a helpful comparison of what to avoid and what to enjoy.


Food Category	Avoid (High Tyramine)	Enjoy (Low Tyramine)
Dairy	Aged cheeses (cheddar, Parmesan, blue, feta)	Fresh cheeses (cottage cheese, ricotta, cream cheese, mozzarella), pasteurized milk, plain yogurt, fresh eggs
Meat & Protein	Cured/processed meats (salami, pepperoni, bacon), aged meat, liver, meat tenderizers	Fresh, properly refrigerated and cooked meats, poultry, and fish
Sauces & Condiments	Soy sauce, fish sauce, teriyaki sauce, yeast extract, fermented condiments	Ketchup, mustard, most salad dressings, vinegar (except wine vinegar)
Fruits & Vegetables	Fava beans, snow peas, dried fruit, overripe fruits	All other fresh, frozen, or canned fruits and vegetables
Beverages	Tap beer, home-brewed beer, red wine, fortified wines	Pasteurized bottled beer, coffee (in moderation and with caution), fresh juices, most spirits

Freshness is Key to Mitigating Risk

Food storage and handling practices are extremely important for anyone taking an MAOI. Tyramine levels naturally increase as food ages or spoils. Even food that is typically low in tyramine can become dangerous if it sits in the refrigerator for too long. To minimize your risk, always prioritize freshness.

Buy fresh meat, poultry, and fish, and cook or freeze it immediately.
Eat cooked meals promptly and avoid consuming leftovers, especially those more than 48 hours old.
If buying canned or frozen foods, consume them right after opening or thawing.
Check expiration dates and discard any item with signs of spoilage.

What to Do If You Experience a Hypertensive Reaction

While following the diet is crucial, it is also important to recognize the symptoms of a hypertensive crisis. These can include a severe headache, stiff or sore neck, nausea, chest pain, and a rapid or pounding heartbeat. If you experience these signs, seek immediate medical help. A doctor can provide emergency treatment to quickly and safely lower your blood pressure.

Conclusion: Prioritizing Your Health with Caution

Adhering to a low-tyramine diet while on MAOI medication is a vital part of your treatment plan, preventing potentially life-threatening complications. By understanding which foods to avoid and practicing vigilant food safety, you can successfully manage your nutrition without compromising your well-being. Always consult with your healthcare provider or a registered dietitian for personalized guidance on your MAOI-friendly diet, as individual reactions can vary. For further reading on this topic, you can consult reliable sources like the Mayo Clinic.

Frequently Asked Questions

MAOIs block the enzyme monoamine oxidase, which normally breaks down the compound tyramine found in certain foods. When you eat tyramine-rich foods while on an MAOI, the tyramine can build up and cause a sudden and severe increase in blood pressure, known as a hypertensive crisis, which can be life-threatening.

A hypertensive crisis from a food interaction can cause symptoms such as a severe headache, a stiff neck, a pounding or fast heartbeat, nausea, and chest pain. It is a medical emergency that requires immediate attention.

No, only aged and strong cheeses are restricted, as they contain high levels of tyramine due to the aging process. Fresh, pasteurized cheeses like cottage cheese, ricotta, cream cheese, and fresh mozzarella are generally safe.

It is not recommended to eat leftovers while on MAOIs because tyramine levels in food increase over time, even with refrigeration. It is safest to eat freshly prepared meals and consume canned or frozen foods immediately after opening.

Most alcohol should be avoided due to the risk of interacting with MAOIs. Tap or home-brewed beers, red wines (especially Chianti), and fortified wines like sherry are particularly high in tyramine and should be strictly avoided. Always consult your doctor before consuming any alcohol while on an MAOI.

You must continue following the low-tyramine diet for at least two to four weeks after you stop taking an MAOI. This is because it takes time for your body's MAO enzyme levels to return to normal.

While earlier guidance sometimes restricted bananas, more recent information suggests fresh, ripe banana pulp contains little to no tyramine. However, you should avoid overripe bananas and their peels, which can contain higher levels. Always consult your healthcare provider for the most current recommendations.