Generic Name: tranylcypromine (tran-ill-SIP-row-meen)
Brand Name: Parnate
Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using tranylcypromine outweigh the risks.
Family and caregivers must closely watch patients who take tranylcypromine. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor.
Tranylcypromine is used for:
Treating depression. It may also be used for other conditions as determined by your doctor.
Tranylcypromine is a monoamine oxidase inhibitor (MAOI). It works by blocking the action of the enzyme (monoamine oxidase) that breaks down the body's mood-elevating chemicals (dopamine, norepinephrine, and serotonin). This produces an increase in the activity of these mood-elevating chemicals.
Do NOT use tranylcypromine if:
- you are allergic to any ingredient in tranylcypromine
- you have a history of stroke, heart disease, congestive heart failure, a brain disease, headaches, liver disease or abnormal liver function tests, high blood pressure, or an adrenal gland tumor (pheochromocytoma)
- you will be having surgery
- you eat foods with a high tyramine content (eg, aged cheeses, sour cream, red wines, beer, bologna, pepperoni, salami, summer sausage, pickled herring, liver, meat prepared with tenderizers, canned figs, raisins, bananas, avocados, soy sauce, fava beans, yeast extracts). Ask your health care provider for a complete list of foods you should avoid.
- you drink alcohol or consume large quantities of foods or drinks that contain caffeine (eg, coffee, tea, chocolate, cola)
- you are taking an amphetamine, an anorexiant (eg, sibutramine, phentermine), an antihistamine (eg, loratadine), apraclonidine, bupropion, buspirone, a catechol-O-methyltransferase (COMT) inhibitor (eg, entacapone), dexmethylphenidate, dextromethorphan, a diuretic (eg, hydrochlorothiazide), certain herbal products (eg, ma huang), levodopa, meperidine, a narcotic pain medicine (eg, codeine), nefazodone, a norepinephrine reuptake inhibitor (eg, atomoxetine), a selective serotonin reuptake inhibitor (SSRI) (eg, fluoxetine, citalopram), a serotonin-norepinephrine reuptake inhibitor (SNRI) (eg, duloxetine, venlafaxine), a sedative, a sympathomimetic (eg, pseudoephedrine, albuterol), tetrabenazine, a tetracyclic antidepressant (eg, mirtazapine), tramadol, trazodone, a triptan (eg, sumatriptan, zolmitriptan), or tryptophan
- you are taking or have taken carbamazepine, cyclobenzaprine, furazolidone, linezolid, maprotiline, another MAOI (eg, phenelzine), or a tricyclic antidepressant (eg, amitriptyline, doxepin) within the last 7 days
- you are taking certain medicine for high blood pressure (eg, guanethidine, methyldopa, reserpine)
Contact your doctor or health care provider right away if any of these apply to you.
Before using tranylcypromine:
Some medical conditions may interact with tranylcypromine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have asthma, bipolar mood disorder, bronchitis, an irregular heartbeat, diabetes, seizures (eg, epilepsy), an overactive thyroid, Parkinson disease, the blood disease porphyria, kidney problems, or heart problems
- if you will be having a certain type of imaging exam (myelography)
- if you have a history of substance or alcohol abuse or dependence
- if you or a member of your family have ever had bipolar disorder, depression, other mental or mood problems (eg, anxiety), or suicidal thoughts or actions
- if you are taking disulfiram
- if you are taking medicine for high blood pressure
- if you are taking a medicine that contains methylene blue
Some MEDICINES MAY INTERACT with tranylcypromine. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Amphetamines, anorexiants (eg, sibutramine, phentermine), antihistamines (eg, loratadine), apraclonidine, bupropion, buspirone, carbamazepine, COMT inhibitors (eg, entacapone), cyclobenzaprine, dexmethylphenidate, dextromethorphan, diuretics (eg, hydrochlorothiazide), certain herbal products (eg, ma huang), furazolidone , levodopa, linezolid, meperidine, narcotic pain medicines (eg, codeine), nefazodone, norepinephrine reuptake inhibitors (eg, atomoxetine), SSRIs (eg, fluoxetine, citalopram), SNRIs (eg, duloxetine, venlafaxine), sedatives, sympathomimetics (eg, pseudoephedrine, albuterol), tetrabenazine , tetracyclic antidepressants (eg, maprotiline, mirtazapine), tramadol, trazodone, tricyclic antidepressants (eg, amitriptyline, doxepin), triptans (eg, sumatriptan, zolmitriptan), tryptophan, certain medicines for blood pressure (eg, guanethidine, methyldopa, reserpine), or another MAOI (eg, phenelzine ) because severe side effects may occur
- Many prescription and nonprescription medicines (eg, used for ADHD, diabetes, depression, Parkinson disease, glaucoma, headaches, heart or blood vessel problems, pain, anesthesia, cold and flu, allergies, high blood pressure, mental or mood problems, weight loss, seizures), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John's wort) may interact with tranylcypromine, increasing the risk of side effects
This may not be a complete list of all interactions that may occur. Ask your health care provider if tranylcypromine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use tranylcypromine:
Use tranylcypromine as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Tranylcypromine comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get tranylcypromine refilled.
- Take tranylcypromine by mouth with or without food.
- Continue to take tranylcypromine even if you feel well. Do not miss any doses.
- If you miss a dose of tranylcypromine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use tranylcypromine.
Important safety information:
- Tranylcypromine may cause drowsiness, dizziness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use tranylcypromine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Eating foods high in tyramine (eg, aged cheeses, red wines, beer, certain meats and sausages, liver, sour cream, soy sauce, raisins, bananas, avocados) while you use an MAOI may cause severe high blood pressure. This could occur for up to 2 weeks after you stop taking an MAOI. Do not eat foods high in tyramine while you take tranylcypromine. Ask your health care provider for a complete list of foods you should avoid. Seek medical attention at once if symptoms of severe high blood pressure occur. These may include severe headache, fast or irregular heartbeat, sore or stiff neck, nausea, vomiting, sweating, enlarged pupils, or sensitivity to light.
- Avoid large amounts of food or drink that have caffeine (eg, coffee, tea, cocoa, cola, chocolate).
- Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using tranylcypromine; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
- Tranylcypromine may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
- Children and teenagers who take tranylcypromine may be at increased risk for suicidal thoughts or actions. Adults may also be affected. The risk may be greater in patients who have had suicidal thoughts or actions in the past. The risk may also be greater in patients who have had bipolar (manic-depressive) illness, or if their family members have had it. Watch patients who take tranylcypromine closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
- Tranylcypromine may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to tranylcypromine. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
- Tell your doctor or dentist that you take tranylcypromine before you receive any medical or dental care, emergency care, or surgery.
- Before you begin taking any new medicine, either prescription or nonprescription, check with your doctor or pharmacist.
- Diabetes patients - Tranylcypromine may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- Lab tests, including blood pressure monitoring, may be performed while you use tranylcypromine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use tranylcypromine with caution in the ELDERLY; they may be more sensitive to its effects, especially difficulty sleeping and enlarged prostate.
- Tranylcypromine should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed. CHILDREN taking tranylcypromine may be at increased risk of suicidal thoughts and behaviors.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using tranylcypromine while you are pregnant. Tranylcypromine is found in breast milk. Do not breast-feed while taking tranylcypromine.
If you stop taking tranylcypromine suddenly, you may have WITHDRAWAL symptoms. These may include restlessness, anxiety, depression, confusion, hallucinations, headache, weakness, and diarrhea.
Possible side effects of tranylcypromine:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Constipation; diarrhea; drowsiness; dry mouth; stomach pain; tremors; upset stomach; weakness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bizarre behavior; blurred vision; chest pain; difficulty sleeping; dilated pupils; dizziness; fainting; fast, slow, or irregular heartbeat; feelings of irritability and hostility; fever; headache; impulsive behavior or other unusual changes in behavior; nausea; new or worsening mental or mood changes (eg, agitation, anxiety, depression); panic attacks; pounding in the chest; sensitivity to light; severe nervousness; severe restlessness; sleeplessness; sore or stiff neck; suicidal thoughts or actions; sweating (sometimes with fever or cold, clammy skin); vomiting.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include agitation; anxiety; confusion; dizziness; drowsiness; excitement; fainting; fast heartbeat; fever; flushing; headache; irritability; muscle twitching; new or worsening trouble sleeping; restlessness; seizures; sweating; weakness.Proper storage of tranylcypromine:
Store tranylcypromine at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep tranylcypromine out of the reach of children and away from pets.
- If you have any questions about tranylcypromine, please talk with your doctor, pharmacist, or other health care provider.
- Tranylcypromine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take tranylcypromine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about tranylcypromine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to tranylcypromine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using tranylcypromine.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.