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Isocarboxazid Dosage

Applies to the following strength(s): 10 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

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

Comments:
-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.

Dose Adjustments

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.

Precautions

BOXED WARNING:
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.

Dialysis

Data not available.

Other Comments

Patient advice:
-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.

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