isocarboxazid

Generic Name: isocarboxazid (eye so kar BOX a zid)
Brand Name: Marplan

What is isocarboxazid?

Isocarboxazid is a monoamine oxidase inhibitor (MAOI) that works by increasing the levels of certain chemicals in the brain.

Isocarboxazid is used to treat symptoms of depression that may include anxiety, panic, or phobias. Isocarboxazid is usually given after other antidepressants have been tried without successful treatment of symptoms.

Isocarboxazid may also be used for purposes not listed in this medication guide.

What is the most important information I should know about isocarboxazid?

There are many other medicines that can cause serious medical problems or death if you take them together with isocarboxazid. Before taking isocarboxazid, tell your doctor about all medicines you have used within the past 5 weeks.

Do not use isocarboxazid if you have used another MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include linezolid, methylene blue injection, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine, and others.

Slideshow: Depression, the Risk of Suicide, and Treatment Options

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using isocarboxazid. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

While you are taking isocarboxazid, you must not drink alcohol or eat foods that are high in tyramine, listed in the "What should I avoid while taking isocarboxazid?" section of this leaflet. Eating tyramine while you are taking isocarboxazid can raise your blood pressure to dangerous levels.

What should I discuss with my doctor before taking isocarboxazid?

You should not take isocarboxazid if you are allergic to it, or if you have:

  • pheochromocytoma (tumor of the adrenal gland);

  • liver disease;

  • kidney disease;

  • a history of stroke or blood clots;

  • heart disease, high blood pressure; or

  • a history of severe or frequent headaches.

There are many other medicines that can cause serious medical problems or death if you take them together with isocarboxazid.

Before taking isocarboxazid, tell your doctor about all medicines you have used within the past 5 weeks. The following drugs should not be used while you are taking isocarboxazid:

  • buspirone (Buspar);

  • carbamazepine;

  • levodopa;

  • methyldopa;

  • tryptophan;

  • certain antidepressants--amitriptylline, bupropion, citalopram, clomipramine, desipramine, doxepin, escitalopram, fluoxetine, fluvoxamine, imipramine, maprotiline, nortriptyline, paroxetine, protriptyline, sertraline, trimipramine (known by brand names such as Celexa, Lexapro, Luvox, Norpramin, Prozac, Paxil, Wellbutrin, and Zoloft);

  • narcotic pain medicine--morphine, tramadol, Demerol, OxyContin, Percocet, Vicodin, and others;

  • ADHD medicine--Adderall, Concerta, Ritalin, Vyvanse, and others;

  • diet pills; or

  • over-the-counter cough or cold medicine.

Do not use isocarboxazid if you have used another MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include linezolid, methylene blue injection, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine, and others.

To make sure isocarboxazid is safe for you, tell your doctor if you have:

  • a history of heart disease or high blood pressure;

  • diabetes;

  • a thyroid disorder;

  • schizophrenia;

  • epilepsy or other seizure disorder; or

  • if you have taken any other antidepressant within the past 5 weeks.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using isocarboxazid. Your family or other caregivers should also be alert to changes in your mood or symptoms.

FDA pregnancy category C. It is not known whether isocarboxazid will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

It is not known whether isocarboxazid passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give isocarboxazid to anyone younger than 16 years old without the advice of a doctor.

How should I take isocarboxazid?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Your blood pressure will need to be tested often. You may also need frequent blood tests to check your liver function.

It may take up to 6 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

If you need surgery, tell the surgeon ahead of time that you are using isocarboxazid. You may need to stop using the medicine for at least 10 days before surgery.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include shallow breathing, fast heart rate, sweating, fever, slow reflexes, feeling light-headed, fainting, or seizure (convulsions).

What should I avoid while taking isocarboxazid?

Avoid coffee, tea, cola, energy drinks, or other products that contain caffeine.

While you are taking isocarboxazid you must not drink alcohol or eat foods that are high in tyramine, including:

  • cheese (especially strong or aged cheeses);

  • sour cream and yogurt;

  • beer (including non-alcoholic beer), sherry, Chianti wine, liqueurs;

  • dry sausage (such as hard salami, pepperoni), anchovies, caviar, liver, pickled herring;

  • canned figs, raisins, bananas;

  • avocados;

  • chocolate;

  • soy sauce;

  • sauerkraut;

  • fava beans;

  • yeast extracts;

  • meat extracts; or

  • meat prepared with tenderizer.

You should become very familiar with the list of foods and medicines you must avoid while you are taking isocarboxazid. Eating tyramine while you are taking isocarboxazid can raise your blood pressure to dangerous levels which could cause life-threatening side effects.

Isocarboxazid may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Isocarboxazid side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Stop taking this medicine and call your doctor at once if you have:

  • sudden and severe headache, rapid heartbeat, stiffness in your neck, nausea, vomiting, cold sweat, vision problems, sensitivity to light;

  • chest pain, fast or slow heart rate;

  • swelling, rapid weight gain;

  • jaundice (yellowing of the skin or eyes); or

  • a light-headed feeling, like you might pass out.

Common side effects may include:

  • headache, dizziness, drowsiness;

  • tremors;

  • sleep problems (insomnia);

  • constipation, nausea; or

  • dry mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Isocarboxazid dosing information

Usual Adult Dose for Depression:

Major Depressive Episode:

Initial dose: 10 mg orally twice a day; increase by 10 mg increments (1 tablet) every 2 to 4 days up to a dosage of 40 mg daily by the end of the first week, then increase by up to 20 mg/week as needed and as tolerated, to a maximum of 60 mg/day. Daily dosage should be divided into two to four doses.

After maximal clinical response is achieved, an attempt should be made to reduce the dose slowly over a period of several weeks without jeopardizing therapeutic effects.

Maintenance dose: usually 40 mg/day in divided doses is effective; however dosage should be adjusted to individual needs. Dosages exceeding 40 mg/day should be administered with caution due to limited controlled clinical data.

What other drugs will affect isocarboxazid?

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking isocarboxazid with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with isocarboxazid, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with isocarboxazid. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about isocarboxazid.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.01. Revision Date: 2014-10-31, 2:38:45 PM.

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