tranylcypromine

Generic Name: tranylcypromine (TRAN il SIP roe meen)
Brand Name: Parnate

What is tranylcypromine?

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

Tranylcypromine is used to treat major depressive episode in adults. This medication is usually given after other anti-depressants have been tried without successful treatment of symptoms. Tranylcypromine will not treat bipolar disorder (manic depression).

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

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

There are many other drugs that can cause serious medical problems if you take them together with tranylcypromine. Do not take tranylcypromine before telling your doctor about all other prescription and over-the-counter medications you use, including vitamins, minerals, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

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Call your doctor at once if you have any new or worsening symptoms 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 tranylcypromine, you must not drink alcohol or eat foods that are high in tyramine, listed in the "What should I avoid while taking tranylcypromine?" section of this leaflet. Eating tyramine while you are taking tranylcypromine can raise your blood pressure to dangerous levels, causing life-threatening symptoms such as sudden and severe headache, confusion, blurred vision, problems with speech or balance, nausea, vomiting, chest pain, seizure (convulsions), and sudden numbness or weakness (especially on one side of the body). Call your doctor at once if you have any of these symptoms.

Tranylcypromine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

What should I discuss with my healthcare provider before taking tranylcypromine?

Do not use this medication if you have used another MAOI such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam) within the past 14 days. Serious, life-threatening side effects can occur if you take tranylcypromine before another MAOI has cleared from your body. If you are switching to tranylcypromine from another MAOI, your doctor may start you at a low dose.

There are many other medicines that can cause serious medical problems if you take them together with tranylcypromine. The following drugs should not be used while you are taking tranylcypromine:

  • an antidepressant;

  • blood pressure medicine such as guanethidine (Ismelin), methyldopa (Aldomet), and reserpine;

  • diet pills, stimulants, ADHD medications, over-the-counter cough and cold or allergy medicines;

  • doxepin (Adapin, Sinequan);

  • carbamazepine (Carbatrol, Tegretol);

  • cyclobenzaprine (Flexeril);

  • maprotiline (Ludiomil);

  • procarbazine (Matulane);

  • bupropion (Wellbutrin, Zyban);

  • venlafaxine (Effexor);

  • buspirone (BuSpar);

  • tryptophan (also called L-tryptophan);

  • levodopa (Larodopa, Parcopa, Sinemet); or

  • meperidine (Demerol, Mepergan).

To make sure you can safely take tranylcypromine, tell your doctor if you have any of these other conditions:

  • heart disease, high blood pressure, circulation problems, or a history of stroke;

  • a history of headaches (migraine, cluster, or other types);

  • diabetes; or

  • a seizure disorder such as epilepsy.

You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Tranylcypromine may be habit forming and should be used only by the person it was prescribed for. Never share tranylcypromine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

It is not known whether tranylcypromine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Tranylcypromine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more likely to have side effects from tranylcypromine.

Do not give this medicine to a child younger than 18 years old without medical advice.

How should I take tranylcypromine?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Your blood pressure will need to be tested often. Visit your doctor regularly.

You may need to stop using the medicine for a short time if you need to have any type of surgery, or if you will have an x-ray, CT scan, or MRI of your spinal cord. Tell any doctor who treats you that you are taking tranylcypromine.

It may take 4 weeks or longer before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 4 weeks of treatment.

Do not stop using tranylcypromine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using tranylcypromine. You may need to use less and less before you stop the medication completely.

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 feeling restless or anxious, sleep problems (insomnia), agitation, confusion, weakness, severe headache, neck pain or stiffness, fast or pounding heart beats, chest pain, cold sweats, feeling light-headed, or fainting.

What should I avoid while taking tranylcypromine?

While you are taking tranylcypromine, you must not eat foods that are high in tyramine, including:

  • avocados, bananas, figs, raisins, and sauerkraut;

  • beef or chicken liver, fish, meats prepared with tenderizer, bologna, pepperoni, salami, summer sausage, game meat, meat extracts, caviar, dried fish, herring, and shrimp paste;

  • beer (alcoholic and nonalcoholic), red wine (especially Chianti), sherry, vermouth, and other distilled spirits;

  • caffeine (including coffee, tea, cola); and

  • cheeses, including American, blue, boursault, brick, brie, camembert, cheddar, emmenthaler, gruyere, mozzarella, parmesan, romano, roquefort, stilton, and Swiss;

  • chocolate;

  • ginseng;

  • sour cream and yogurt;

  • soy sauce, miso soup, bean curd, fava beans; or

  • yeast extracts.

Eating tyramine while you are taking tranylcypromine can raise your blood pressure to dangerous levels, causing life-threatening side effects.

Drinking alcohol can increase certain side effects of tranylcypromine.

Tranylcypromine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Tranylcypromine 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 using tranylcypromine and call your doctor at once if you have any of these serious side effects:

  • frequent headaches, vision problems, sensitivity to light;

  • fast or pounding heart beats, tight feeling in your chest or throat;

  • swelling of your ankles or feet;

  • pale skin, easy bruising or bleeding, unusual weakness;

  • nausea, vomiting, dizziness, sweating, stiffness in your neck;

  • confusion, lack of coordination, feeling light-headed, fainting; or

  • tremors, muscle twitches you cannot control.

Less serious side effects may include:

  • feeling restless, weak, or drowsy;

  • nausea, diarrhea or constipation, loss of appetite, stomach pain;

  • chills, numbness or tingly feeling;

  • dry mouth, decreased urination;

  • blurred vision, ringing in your ears; or

  • impotence, difficulty having an orgasm.

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)

Tranylcypromine Dosing Information

Usual Adult Dose for Depression:

Major Depressive Episode Without Melancholia:
Initial dose: 10 mg orally twice a day
Maintenance dose: Usually 30 mg/day in divided doses is effective; however, dosage should be adjusted to individual needs

Improvement should be seen within 48 hours to 3 weeks after initiation of therapy. If there are no signs of improvement after 2 weeks, then the dosage may be increased in 10 mg/day at intervals of 1 to 3 weeks, up to a maximum of 60 mg/day.

What other drugs will affect tranylcypromine?

There are many other drugs that can cause serious medical problems if you take them together with tranylcypromine. Do not take tranylcypromine before telling your doctor about all other prescription and over-the-counter medications you use, including vitamins, minerals, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about tranylcypromine.
  • 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: 5.01. Revision Date: 2011-03-28, 10:42:22 AM.

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