Generic name: tranylcypromine [ TRAN-il-SIP-roe-meen ]
Brand name: Parnate
Dosage form: oral tablet (10 mg)
Drug class: Monoamine oxidase inhibitors
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 episodes in adults when other medicines have not been effective.
Tranylcypromine may also be used for purposes not listed in this medication guide.
Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.
There are many other drugs, foods, and beverages that can cause serious medical problems if you take them together with tranylcypromine. Tell your doctor about all your current medicines and any you start or stop using. Avoid drinking alcohol, and learn about the foods you should avoid.
Eating foods that contain a lot of tyramine while taking tranylcypromine can cause dangerously high blood pressure. Symptoms include a sudden and severe headache, nausea, vomiting, fever, cold sweat, dilated pupils, light sensitivity, fast or pounding heartbeats, neck stiffness, weakness, or problems with vision or speech.
Before taking this medicine
You should not use tranylcypromine if you are allergic to it, or if you have:
pheochromocytoma (tumor of the adrenal gland).
A dangerous drug interaction could occur between tranylcypromine and certain other medications you used in the past 14 days. You should not take tranylcypromine if you also use:
buspirone, carbamazepine, reserpine, tapentadol, tetrabenazine, tryptophan, SAM-e;
diet pills, stimulants, ADHD medications, cough and cold or allergy medicines;
another MAO inhibitor--isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, and others; or
drugs that affect serotonin levels in your body--stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.
Tell your doctor if you have ever had:
heart disease, high or low blood pressure, circulation problems, or a stroke;
bipolar disorder (manic depression);
a thyroid disorder;
diabetes (tranylcypromine may cause low blood sugar); or
Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.
Tranylcypromine may harm an unborn baby. Tell your doctor if you are pregnant or if you become pregnant.
You should not breast-feed while using tranylcypromine.
Tranylcypromine is not approved for use by anyone younger than 18 years old.
How should I take tranylcypromine?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Your blood pressure will need to be checked often.
You may need to stop using tranylcypromine for a short time before any type of surgery or medical procedure. Tell any doctor who treats you that you take tranylcypromine.
It may take a few weeks before you receive the full benefit of taking tranylcypromine. Your doctor will determine how long to treat you with tranylcypromine.
Do not stop using tranylcypromine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
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, agitation, confusion, weakness, severe headache, neck pain or stiffness, pounding heartbeats, or loss of consciousness.
What should I avoid while taking tranylcypromine?
Do not drink alcohol. Dangerous side effects could occur.
You must not eat foods that are high in tyramine, including:
air dried, aged or fermented meats, including sausage or salami;
beer on tap (not in a bottle or can);
aged cheeses, including blue, boursault, brie, camembert, cheddar, gruyere, mozzarella, parmesan, Romano, Roquefort, and Swiss;
moldy or improperly stored meat, fish, poultry, or liver;
soy sauce, miso soup, bean curd, fava beans; or
yeast extracts, Marmite.
Eating tyramine while you are taking tranylcypromine can raise your blood pressure to dangerous levels, causing life-threatening side effects. Also avoid tyramine for 2 weeks after you stop taking tranylcypromine.
Avoid driving or hazardous activity until you know how tranylcypromine will affect you. Your reactions could be impaired.
Tranylcypromine side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult 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.
Tranylcypromine may cause serious side effects. Call your doctor at once if you have:
dilated pupils, vision problems, sensitivity to light;
sudden and severe headache, neck pain or stiffness;
numbness or weakness, problems with vision or speech;
fast or pounding heartbeats;
fever, cold sweat, nausea, vomiting;
a light-headed feeling, like you might pass out;
manic episodes--racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, being agitated or talkative;
high levels of serotonin in the body--agitation, hallucinations, sweating, shivering, muscle stiffness, twitching, loss of coordination, vomiting, diarrhea; or
liver problems--loss of appetite, stomach pain (upper right side), dark urine, jaundice (yellowing of the skin or eyes).
Serious side effects may be more likely in older adults.
Common side effects of tranylcypromine may include:
dry mouth, blurred vision;
feeling shaky or excited.
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.
Tranylcypromine dosing information
Usual Adult Dose for Depression:
30 mg per day, orally, in divided doses
-If improvement does not occur in a reasonable period (up to 2 weeks), the dose may be increased by 10 mg per day at 1 to 3 week intervals.
-Maximum dose: 60 mg/day
-Adjust dosage to the requirements of the individual patient.
-Improvement usually occurs within 48 hours to 3 weeks after starting therapy.
-Suitable candidates for treatment are patients who have failed to respond to drugs more commonly used to treat depression.
-The effectiveness in patients with major depression with melancholia (endogenous features) has not been established.
Use: Treatment of major depressive episode without melancholia
What other drugs will affect tranylcypromine?
When you start or stop taking tranylcypromine, your doctor may need to adjust the doses of any other medicines you take on a regular basis.
There are many other drugs that can cause serious medical problems if you take them together with tranylcypromine. 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 your current medicines and any medicine you start or stop using.
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