Applies to the following strength(s): 10 mg
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Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Depression
Initial dose: 10 mg, orally, 2 times a day
-Increase by 10 mg every 2 to 4 days, until 40 mg per day is reached (by the end of the first week of treatment); divide into 2 to 4 doses per day
-After first week, may increase by up to 20 mg per week, if needed and tolerated
Maximum recommended dose: 60 mg, divided into 2 to 4 doses per day
-Adjust dose based on careful observation of the patient.
-After maximum clinical response is achieved, try to reduce dose slowly over several weeks without jeopardizing therapeutic response.
-Benefits may not be seen for 3 to 6 weeks; if no response in this time, continued use is unlikely to help.
-Use caution if a dose above 40 mg per day is used.
Renal Dose Adjustments
Contraindicated in severe renal impairment
Liver Dose Adjustments
Contraindicated in patients with a history of liver disease and in patients with abnormal liver function tests.
If the patient is being transferred to isocarboxazid from another MAO inhibitor or from a dibenzazepine (e.g., tricyclic antidepressants), allow a medication-free interval of at least a week, then initiate isocarboxazid at half the normal starting dosage for at least the first week of therapy.
Suicidality and Antidepressant drugs
-Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies with Major Depressive Disorder (MDD) and other psychiatric disorders, compared to placebo.
-Anyone considering use of any antidepressants in children, adolescents, or young adults must balance risk with clinical need.
-Short-term studies did not show increased suicidality risk in adults beyond 24 years old.
-Risk of suicidality was reduced in adults aged 65 and older.
-Depression and certain other psychiatric disorders are themselves associated with increased risk of suicide.
-Patients of all ages who are started on antidepressants should be monitored and observed appropriately for clinical worsening, suicidality, or unusual changes in behavior.
-Advise family and caregivers of the need for close observation and communication with the prescriber.
-This drug is not approved for use in pediatric patients.
-Pooled analyses of short term (4 to 16 weeks) trials of 9 antidepressants (SSRIs and others) in children and adolescents with MDD, obsessive compulsive disorder (OCD), or other psychiatric disorders revealed a greater risk of suicidality during the first few months of treatment; the average risk was 4% in patients on antidepressants, twice the placebo risk of 2%. No suicides occurred in these trials.
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Data not available.
-Promptly report headache or other unusual symptoms (i.e. palpitation or tachycardia, sense of constriction in the throat or chest, sweating, dizziness, neck stiffness, nausea, or vomiting).
-Do not eat foods listed under contraindications and do not drink alcoholic beverages.
-There is a possibility of hypotension and faintness, as well as drowsiness that may impair performance of hazardous tasks, such as driving or operating machinery.
-Do not consume excessive caffeine in any form.
-Inform physicians and dentists about your use of this drug.
More about isocarboxazid
- Other brands: Marplan