Marplan Disease Interactions

The use of monoamine oxidase inhibitor (MAOI) antidepressants is contraindicated in patients with cerebrovascular or cardiovascular disease, including hypertension and congestive heart failure. Nonspecific MAOIs inhibit the breakdown of pressor amines, the accumulation of which can precipitate hypertensive crises. Intracranial hemorrhage and death have resulted in some cases. MAOI antidepressants are also commonly associated with dose-related orthostatic hypotension, which occurs most frequently in patients with preexisting hypertension but may be minimized with slow, gradual titration. Blood pressure should be monitored closely in all patients who receive MAOI therapy, and patients should be advised to stop taking the medication and seek medical attention immediately if signs and symptoms of a hypertensive reaction occur (e.g., occipital headache which may radiate frontally; palpitation; neck stiffness or soreness; nausea or vomiting; perspiration associated with fever or cold, clammy skin; mydriasis; photophobia; constricting chest pain).

The use of nonspecific monoamine oxidase inhibitors (MAOIs) is contraindicated in patients with carcinoid syndrome. Nonspecific MAOIs inhibit the breakdown of pressor amines, including serotonin, and may exacerbate symptoms of the syndrome.

The use of monoamine oxidase inhibitor (MAOI) antidepressants is contraindicated in patients with a history of headaches. Nonspecific MAOIs inhibit the breakdown of pressor amines, the accumulation of which can precipitate hypertensive crises. Intracranial hemorrhage and death have resulted in some cases. Since headache may often be the first symptom of a hypertensive reaction during MAOI therapy, use of these agents is not recommended in patients who experience frequent or severe headaches. MAOIs should be withdrawn promptly if headaches develop during treatment.

Nonspecific monoamine oxidase inhibitors (MAOIs) inhibit the breakdown of pressor amines, the accumulation of which can precipitate hypertensive crises. Intracranial hemorrhage and death have resulted in some cases. Therapy with nonspecific MAOIs should be administered cautiously in patients with hyperthyroidism, since these patients have an increased sensitivity to pressor amines. Blood pressure should be monitored closely during therapy, and patients should be advised to stop taking the medication and seek medical attention immediately if signs and symptoms of a hypertensive reaction occur (e.g., occipital headache which may radiate frontally; palpitation; neck stiffness or soreness; nausea or vomiting; perspiration associated with fever or cold, clammy skin; mydriasis; photophobia; constricting chest pain).

The use of monoamine oxidase inhibitor (MAOI) antidepressants is contraindicated in patients with abnormal liver function tests or a history of liver disease. A low incidence of altered liver function or hepatocellular jaundice has been reported in association with the use of MAOI antidepressants. Periodic monitoring of liver function tests is recommended during prolonged and/or high-dose therapy.

The use of nonspecific monoamine oxidase inhibitors (MAOIs) is contraindicated in patients with pheochromocytoma or other tumors of the adrenal medulla, such as some neuroblastomas, that secrete pressor substances. Nonspecific MAOIs inhibit the breakdown of pressor amines, the accumulation of which can precipitate hypertensive crises. Intracranial hemorrhage and death have resulted in some cases.

The use of monoamine oxidase inhibitor (MAOI) antidepressants is contraindicated in patients with severe renal dysfunction. These drugs may accumulate in plasma when renal function is impaired.

The use of monoamine oxidase inhibitors with alcohol or any other CNS depressants is contraindicated.

The use of most monoamine oxidase inhibitors (MAOIs) is contraindicated in patients with diagnosed cardiovascular disease, hypertension, or confirmed or suspected cerebrovascular disorders. These drugs can cause hypertensive crises, which sometimes can be fatal, and are characterized by occipital headache, palpitations, neck stiffness or soreness, nausea, sweating, dilated pupils and photophobia. Intracranial bleeding has been reported in some cases in association with the increase in blood pressure.

Normotensive patients receiving therapy with MAOIs need to have monitored their blood pressure frequently to detect any evidence of pressor response and treatment should be discontinued immediately if blood pressure increases or the patient reports symptoms such a headaches or palpitations. Additionally, patients should be advised to avoid foods and drinks with high tyramine content such as cheese, sour cream, beer, liver, bananas and others, as these might trigger an hypertensive crisis.

The use of monoamine oxidase inhibitors is contraindicated in patients with a history of liver disease or in those with abnormal liver function tests.

The use of most monoamine oxidase inhibitors (MAOIs) is contraindicated in patients with pheochromocytoma, as such tumors secrete pressor substances whose metabolism may be inhibited by these drugs.

The use of some monoamine oxidase inhibitors such as isocarboxazid and phenelzine, is contraindicated in patients with severe renal impairment.

There has been a low incidence of altered liver function and jaundice in patients receiving isocarboxazid. This drug should be used with caution in patients with any history of liver disease. Periodic liver chemistry tests should be performed during therapy and the use of the drug should be discontinued at the fist sign of hepatic dysfunction or jaundice.

Isocarboxazid should be used with caution in hyperthyroid patients because of their increased sensitivity to pressor amines.

There is conflicting evidence regarding whether monoamine oxidase inhibitors (MAOIs) affect glucose metabolism or potentiate oral hypoglycemic agents. Therapy with MAOIs should be administered cautiously in patients with diabetes.

Nonspecific monoamine oxidase inhibitors (MAOIs) may increase the frequency and severity of signs and symptoms associated with parkinsonian syndrome. Therapy with nonspecific MAOIs should be administered cautiously in patients with this disorder.

Monoamine oxidase inhibitor (MAOI) antidepressants may cause excessive stimulation in hyperactive or schizophrenic patients. Symptoms of psychosis may be aggravated in schizophrenia, particularly that with paranoid symptomatology. Depressed patients, usually those with bipolar disorder, may experience a switch from depression to mania or hypomania. Therapy with MAOI antidepressants should be administered cautiously in patients with hyperactive or hyperexcitable personalities, schizophrenia or bipolar disorder.

Monoamine oxidase inhibitor (MAOI) antidepressants may have variable effects on seizure threshold. Decreased seizure frequency as well as increased frequency have been reported. Therapy with MAOI antidepressants should be administered cautiously in patients with a history of seizures.

Monoamine oxidase inhibitors may have the capacity to suppress anginal pain that would otherwise serve as a warning of myocardial ischemia. Caution is advised in patients with a history of angina or risk of myocardial infarction.

A major depressive episode can be the initial presentation of bipolar disorder. Patients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder prior to initiating treatment with a monoamine oxidase inhibitor (MAOI). This screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression. It should be noted that MAOIs antidepressants are not approved for use in treating bipolar depression.

Monoamine oxidase inhibitors can increase the sensitivity to insulin, and have contributed to hypoglycemic episodes in patients with diabetes. Caution should be used when prescribing in diabetic patients.

Hypotension has been observed during therapy with monoamine oxidase inhibitors. These drugs should be used with caution, especially in patients with tendency towards hypotension or taking other drugs known to cause hypotension.

Monoamine oxidase inhibitors should be used with caution in patients with renal impairment as there is a possibility of cumulative effects in such patients. Dose selection should be cautious, usually starting at the low end of the dosing range.

Some monoamine oxidase inhibitors such as isocarboxazid and phenelzine, should be used cautiously in hyperactive and agitated patients, as well as schizophrenic patients, as these may cause excessive stimulation. Additionally, activation of mania/hypomania has been reported in a small portion of patients with major affective disorders.

Monoamine oxidase inhibitors have shown a variable effect on the convulsive threshold. Caution should be used when treating patients with epilepsy.