PMA

Pre-existing hypertension increases risk of cardiovascular crisis during PMA intoxication. Acute cardiorespiratory failure is the primary cause of death in PMA fatalities.

Pre-existing cardiac arrhythmias are absolutely contraindicated given PMA's documented cardiovascular lethality.

Asthma and respiratory conditions are relative contraindications given respiratory failure as a documented cause of death in PMA poisoning.

Epilepsy is absolutely contraindicated. Seizures are a documented feature of PMA toxicity and a contributing factor in fatal outcomes.

Hepatic impairment is a relative contraindication given PMA's probable hepatic metabolism via CYP2D6 and documented liver failure in severe toxicity.

Renal impairment is a relative contraindication given documented acute kidney failure in PMA toxicity and the high incidence of rhabdomyolysis in amphetamine-class intoxication (30.5%).

Pregnancy is an absolute contraindication. No reproductive safety data exist for PMA, and its severe toxicity profile precludes any use during pregnancy.

moclobemide, phenelzine, tranylcypromine, selegiline, isocarboxazid

Concurrent use of any MAO inhibitor with PMA is absolutely contraindicated. The combination can be lethal at any PMA dose due to compounded MAO-A inhibition amplifying serotonergic crisis.