Phenelzine Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Depression

Initial dose: 15 mg orally 3 times daily.
Maintenance dose: Dosage should be increased to at least 60 mg daily and in some cases 90 mg daily will be required to obtain sufficient MAO inhibition. After maximum benefit has been achieved, the dose may be reduced slowly over several weeks to 15 mg daily or every other day.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

Blood pressure should be monitored regularly to detect changes in pressor response, if hypertensive crisis occurs therapy should be discontinued immediately.

If palpitations or frequent headaches occur during therapy, phenelzine should be discontinued immediately.

Suicide is an inherent risk in any depressed patient. Patients should be closely supervised and dispensed the smallest quantity of drug possible while receiving phenelzine therapy or any other therapy for depression.

Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior. The risk of suicidality appears to be greatest during the first few months of treatment, or when there is a dosage change.

Families and caregivers should be advised to closely observe the patient and to communicate with the prescriber.

Discontinuation should be performed gradually in order to minimize the risk of withdrawal symptoms.

Concomitant administration of other antidepressants is contraindicated. Patients should discontinue phenelzine therapy 14 days prior to initiating treatment with other antidepressants including bupropion, serotoninergic agents, and dibenzazepine derivatives. Initiation of phenelzine therapy should begin at least 14 days after discontinuation of other antidepressants, except for fluoxetine, which requires 5 weeks between discontinuation and initiation of phenelzine therapy.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

Phenelzine is only recommended for use in patients who have not responded to treatment with other antidepressant agents.

All patients should be advised to avoid the following foods and medications during phenelzine therapy and for two weeks after discontinuing use: pickled herring, liver, dry sausage, broad bean pods, sauerkraut, aged cheese, yogurt, beer and wine, alcohol-free and reduced-alcohol beer and wine products, yeast extract, meat extract, excessive amounts of chocolate and caffeine, cough and cold preparations, nasal decongestants (tablets, drops, or sprays), asthma inhalant medications, weight-loss agents, and L-tryptophan containing preparations.

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