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Tranylcypromine Pregnancy and Breastfeeding Warnings

Tranylcypromine is also known as: Parnate

Tranylcypromine Pregnancy Warnings

Tranylcypromine has not been formally assigned to a pregnancy category by the FDA. Tranylcypromine crosses the placenta in rats. There are no controlled data in human pregnancy. Tranylcypromine is only recommended for use during pregnancy when benefit outweighs risk.

In a review of 21 mother-child pairs exposed to monoamine oxidase inhibitors in the first trimester by the Collaborative Perinatal Project, 13 of the pairs were exposed to tranylcypromine. Of the 21 infants, three had malformations. However, details with respect to tranylcypromine exposure were unavailable. A 41-year-old woman treated with tranylcypromine (100 mg/day), pimozide (1 mg/day) and diazepam (5 to 10 mg/day) for severe depression delivered a stillborn fetus at 31-weeks gestation. Upon examination the stillborn infant revealed hypertelorism, a large atrioventricular septal defect, a single coronary ostium, and a right pulmonary isomerism. In addition, the placenta had multiple infarcts that may have contributed to the fetal death. In her second pregnancy, an ultrasound at 19-weeks gestation showed a fetus with a 'lemon-shaped' head. In another case, a female infant was delivered at 38-weeks gestation because of poor growth. The infant also had multiple defects including hypertelorism, low-set overfolded ears, cleft palate, micrognathia, distal phalangeal hypoplasia, agenesis of the corpus callosum, and atrioventricular septal defect. These outcomes have been attributed to tranylcypromine and possibly a result of reduced uterine and placental blood flow.

Tranylcypromine Breastfeeding Warnings

Tranylcypromine is excreted into human milk. There are no data on the use of tranylcypromine during lactation, and the potential effects in a nursing infant are unknown. Tranylcypromine is only recommended for use during lactation when benefit outweighs risk.

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