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PARNATE 10MG COATED TABLETS

Active substance(s): TRANYLCYPROMINE SULPHATE

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PACKAGE LEAFLET: INFORMATION FOR THE USER

PARNATE® 10MG COATED TABLETS

Parnate MUST NOT be taken with the following
medicines:
ƒ

(Parnate sulphate)
Your medicine is available using the name Parnate 10mg Coated
Tablets but will be referred to as Parnate throughout this leaflet.

Read all of this leaflet carefully before you start
taking this medicine.

Keep this leaflet. You may need to read it again. If you have any
further questions, ask your doctor or pharmacist. This medicine
has been prescribed for you. Do not pass it on to others.
It may harm them, even if their symptoms are the same as yours.
If any of the side effects become serious, or if you notice any side
effects not listed in this leaflet, please tell your doctor or
pharmacist.

ƒ
ƒ
ƒ
ƒ

ƒ
ƒ

In this leaflet:

1.
2.
3.
4.
5.
6.

What Parnate is and what it is used for
Before you take Parnate
How to take Parnate
Possible side effects
How to store Parnate
Further information

1. What Parnate is and what it is used for
Parnate contains the active substance tranylcypromine which
belongs to a group of antidepressant medicines known as
monoamine oxidase inhibitors (MAOIs). It works by stopping the
breakdown of two substances in the brain called serotonin and
noradrenaline. Your medicine should help bring these substances
back to normal levels.
Parnate is used to treat moderate to severe depression. It can
also help feelings of fear (phobia) which sometimes occurs in
depression. This medicine is often used when other types of
antidepressant medicines have not worked.

2. Before you take Parnate
DO NOT take Parnate if:

ƒ

ƒ
ƒ
ƒ
ƒ
ƒ
ƒ
ƒ
ƒ
ƒ

Medicines called sympathomimetic agents - these include
ephedrine, pseudoephedrine, adrenaline and noradrenaline
(these may be found in medicines used to treat heart
problems and asthma as well as some decongestants and
cough/cold remedies e.g. dextromethorphan bought without
a prescription)
Bupropion, a medicine to help you stop smoking
Medicines for migraine e.g. 5HT1 agonists
Strong pain killers e.g. pethidine, morphine, codeine and
nefopam
It should not be administered at the same time as, or within
14 days of treatment with other MAOIs such as isocarboxid,
buspirone, or dibenzazepine derivative drugs (including
tricyclic antidepressant agents, perphenazine or
carbemazepine).
Medicines used to treat depression (e.g. clomipramine,
imipramine, venlafaxine)
Parnate should not be administered together with
clomipramine and imipramine. In the cases of clomipramine
and imipramine, 3 weeks should be left before starting
Parnate therapy.
Parnate should not be administered in combination with
selective serotonin reuptake inhibitors (SSRIs) e.g.,
fluoxetine or serotonin/noradrenaline reuptake inhibitors
(SNRIs) e.g. venlafaxine. Therefore SSRIs and SNRIs should
not be used in combination with an MAOI, or within 14 days
of discontinuing therapy with an MAOI.
Buspirone, used to treat anxiety
Medicines to treat seizures/fits, e.g. carbamazepine
Perphenazine used to treat schizophrenia
Guanethidine used to treat high blood pressure
SSRIs such as fluoxetine, paroxetine or sertaline (for
depression)
Medicines like altretamine used for the treatment of cancer
Doxapram used to increase the rate of breathing, especially
during surgery
Medicines like oxypertin, clozapine used for the treatment of
mental disorders like schizophrenia
Tetrabenazine used for the treatment of excessive
restlessness.

Parnate 10mg Tablets must be taken with caution if
you are taking the following medicines:

You know that you are allergic to tranylcypromine or any of
the other ingredients of Parnate (see section 6 of this
leaflet).
ƒ
You are taking clomipramine, imipramine and venlafaxine.
ƒ
You suffer from porphyria which is an inherited disease
affecting the nervous system and skin.
ƒ
You have severe heart disease or any disease of the blood
vessels of the brain
ƒ
You have pheochromocytoma which is a tumour of the
adrenal glands (glands near the kidneys) causing high blood
pressure.
ƒ
You have known liver damage or a disorder affecting the
blood cells (your doctor will know).
ƒ
You are pregnant, trying to become pregnant or breastfeeding
ƒ
You are in a manic phase
ƒ
You are taking any of the medicines listed under “Do not
take” in the Taking Other Medicines section of this leaflet.
Please tell your doctor if any of the above applies to you.

Barbiturates used to treat severe sleeping problems, e.g.
amylobarbitone
ƒ
Medicines used to treat depression (e.g. amitriptyline,
imipramine, tryptophan, amfebutamone)
ƒ
Phenylpropanolamine used to treat nasal congestion
associate with allergies
ƒ
Medicines for high blood pressure (e.g. reserpine,
methyldopa)
ƒ
Medicines to control appetite, e.g. amphetamine and
fenfluramine
ƒ
Antimuscarinics for motion sickness, muscle cramps in the
gut or bladder
ƒ
Medicines that treat Parkinson’s disease, e.g. levodopa
ƒ
Dopamine, a medicine used to treat certain heart conditions
ƒ
Local anaesthetics e.g. lidocaine
ƒ
Medicines to treat diabetes (e.g. insulin, metformin).
At least 5 weeks should be allowed after stopping fluoxetine
before starting Parnate.
At least 2 weeks should be allowed after stopping paroxetine
before starting Parnate.

Take special care with Parnate and talk to your
doctor if you:

Taking Parnate 10mg Tablets with food and drink:

ƒ

ƒ
are elderly
ƒ
have a mild heart problem which restricts your activity
ƒ
suffer from seizures/fits (epilepsy)
ƒ
suffer from diabetes mellitus (sugar diabetes)
ƒ
suffer from blood disorders
ƒ
taking diuretics (water tablets)
ƒ
are due to have surgery in the next few weeks
ƒ
have depression or suicidal thoughts
ƒ
suffer from low blood pressure or high blood pressure
ƒ
suffer from schizophrenia
ƒ
have a history of dependence on drugs or alcohol.
Even though some of the above may be obvious, it is important
that your doctor is aware if any of them apply to you.

Taking other medicines:

Please tell your doctor or pharmacist if you are taking or have
recently taken any other medicines, including medicines obtained
without a prescription.

ƒ

You should NOT take alcohol (especially red wine) whilst you are
taking Parnate. This includes non-alcoholic beer or lager.
Parnate stops the breakdown of a substance called tyramine which
is found in large amounts of certain foods. If this substance is not
broken down, it can cause very high blood pressure. So, whilst
you are taking Parnate, you should avoid the following foods:
ƒ
Matured cheeses – cooked or plain (e.g. cheddar or
processed cheese made from mature cheese)
ƒ
Yeast extracts (e.g. Bovril, Oxo, brewer’s yeast or Marmite)
ƒ
Meat, fish or poultry which is not fresh or has been pickled
or aged e.g. hung game, pickled herrings
ƒ
Broad bean pods
ƒ
Flavoured textured vegetable protein
ƒ
Protein foods that are not fresh and whose preparation
involved hydrolysis, fermentation, pickling, hanging,
smoking or bacterial contamination e.g. dry sausage
(salami, pepperoni etc.), fermented soya bean extract, liver,
yoghurt
ƒ
Excessive amounts of chocolate
ƒ
Excessive amounts of tea or coffee.

Pregnancy and breast-feeding

Please let the doctor know if you are pregnant, think you might be
pregnant, are planning to become pregnant or are breast-feeding.
Parnate should NOT be used during pregnancy or breast feeding
unless your doctor thinks it is essential. This medicine may pass
into breast milk.
Ask your doctor or pharmacist for advice before taking any
medicine.

Page 1 of 2

Driving and using machines

Parnate may make you feel drowsy or dizzy or affect your
concentration. You should not drive or use machines when you
first start to take this medicine until you are certain that you are
not getting these side effects. If in any doubt, speak to your
doctor before you drive or use machines.

Important information about some of the
ingredients of Parnate

This medicine also contains carmoisine (E122) and Ponceau 4R
(E124) which may cause allergic reactions.
This medicine also contains sucrose (a sugar). If you have been
told by your doctor that you have an intolerance to some sugars,
contact your doctor before taking this medicine.

If you have an operation or you need to go to the
Dentist:

Parnate 10mg Tablets are not normally taken for two weeks
before an operation or major dentistry. Check with your doctor or
dentist and alert them to your medication.

3. How to take Parnate
Always take Parnate exactly as your doctor has told you. Do NOT
take more than your doctor tells you to. You should check with
your doctor or pharmacist if you are not sure.
Swallow the tablets whole with a glass of water.
USUAL DOSE (Adults only)
ƒ
One tablet in the morning and one tablet in the afternoon
each day.
ƒ
Try to take the last dose before 3 o’clock in the afternoon.
ƒ
This dose may be increased by your doctor to three tablets a
day. Take the extra tablet at midday.
ƒ
If you are elderly your doctor will usually prescribe you a
lower dose.
When you start to feel better, your doctor may change your dose
to one tablet a day.
Do NOT take more than three tablets each day unless your doctor
tells you.
Children: Parnate is not recommended for children under 18
years old.

If you take more Parnate than you should:

If you think that you, or any other person, have taken too many
tablets, contact your doctor or hospital casualty department
immediately. Take any remaining tablets and this leaflet with you
so that the medical staff know exactly what you have taken.

If you forget to take your Parnate:

If you miss a dose, wait until your next dose. Do not take the
dose you have missed. You can then carry on as before. Do not
take more than one dose at a time.

If you stop taking Parnate

Continue to take Parnate even if you no longer feel ill. DO NOT
STOP taking this medicine without talking with your doctor first,
especially if you have taken large doses for a long time. When the
time comes to stop your doctor will probably decrease your dose
gradually as stopping the tablets suddenly may cause ill-effects
such as nausea (feeling sick), vomiting (being sick), sweating,
vivid nightmares, fits, worsening of symptoms and difficulty in
sleeping.
If you have any further questions on the use of this medicine, ask
your doctor or pharmacist.

4. Possible side effects
Like all medicines, Parnate can sometimes cause side effects,
although not everybody gets them. If you eat foods or take
medicines which interact with the active ingredient, Parnate, you
may get very high blood pressure (a hypertensive crisis).
If you notice any of the following symptoms please see your
doctor immediately.
ƒ
frequent headaches, shakiness, nervousness, excessive
happiness or excitement (euphoria), painful or stiff neck,
changes in heart rate, pain in the middle of the chest,
feeling sick or being sick, sweating, paleness, or flushing of
the skin and enlarged pupils which may make bright sunlight
uncomfortable, muscle twitching, muscle jerks, increased
reflexes, feeling nervous or uneasy. Although very rare,
muscle rigidity, fever and irregular body movements (i.e.
neuroleptic malignant syndrome), severe problems with the
heart and breathing, changes in the metabolism may occur,
feeling of a lump in the throat, increased muscular
movements, coma
ƒ
thought of suicide and suicidal behaviour early on in
treatment or shortly after stopping treatment.

If this occurs contact your doctor or go to a hospital
straight away.

Very rarely, liver problems (symptoms include yellowing of the
skin and the whites of the eyes), bruising and changes in blood
have been reported. Therefore, if you get a bad sore throat or
high fever or become very tired and pale or notice bruises and
nose bleeds, tell your doctor.
Sometimes patients feel anxious whilst taking this medicine and
rarely some patients will become very agitated or irritable. Your
doctor may reduce your dose if this happens.
Other side effects which may occur include:
ƒ
difficulty in sleeping, mild headache, sleepiness, weakness,
dizziness, fast or irregular heart beat (palpitations),
restlessness, dry mouth, inability to normally open mouth,
blurred vision, feeling sick, water retention or swelling,
difficulty in passing stools, other tummy problems,
swelling,increase in the level of liver enzymes on
examination, squint in the eyes, decrease in the blood cell
count in the body, sexual problems, confusion, reduced or
increased levels of salt in the body, repetition or echoing of
one's own spoken words, fits, glaucoma (increased pressure
in the eyes) itching, tingling or pricking of skin, altered
driving abilities, weight gain, increased appetite, rash, being
sick, diarrhoea, fatigue, hallucinations and difficulty in
passing water.

Manufacturer

Manufactured by: Dales Pharmaceuticals Ltd., Snaygill Industrial
Estate, Keighley Road, Skipton, North Yorkshire, BD23 2RW.
Procured from within the EU and repackaged by: Doncaster
Pharmaceuticals Group Ltd., Kirk Sandall, Doncaster, DN3 1QR.
Product Licence holder: Landmark Pharma Ltd., 7 Regents Drive,
Prudhoe, Northumberland, NE42 6PX.
PL No: 21828/0496

POM

Leaflet revision and issue date: 12.11.13
Parnate® is a registered trademark of Goldshield Group PLC.

Some patients get low blood pressure and may feel dizzy on
standing up. If this continues for a long time, your doctor may
stop your medicine.
Rarely some patients experience soreness in the hands and feet
which may be a sign of inflamed nerves, spasm of the axial
muscles.
If any of the side effects become serious, or if you notice
any side effects not listed in this leaflet, please tell your
doctor or pharmacist.
You may find it helpful to tell a relative or close friend that
you are depressed or have anxiety disorder, and to ask
them to read this leaflet. You might ask them to tell you if they
think your depression or anxiety is becoming worse or if they are
worried about changes in your behaviour.
Also you can help to make sure that medicines remain as safe as
possible by reporting any unwanted side effects via the internet at
www.mhra.gov.uk/yellowcard. Alternatively you can call
Freephone 0808 100 3352 (available from 10 a.m. to 2 p.m.
Mondays to Fridays) or fill in a paper form available from your
local pharmacy.

5. How to store Parnate
KEEP OUT OF THE SIGHT AND REACH OF CHILDREN.
Do not use Parnate after the expiry date which is stated on the
box. The expiry date refers to the last day of that month. If your
tablets are out of date, take them to your pharmacist who will get
rid of them safely.
Do not store above 25°C (normal room temperature).
Store in the original package and protect from light and moisture.
Keep container tightly closed.
If your tablets appear to be discoloured or show any other signs of
deterioration, take them to your pharmacist who will advise you.
If your doctor decides to stop treatment, return any leftover
tablets to the pharmacist. Only keep them if your doctor tells you
to.
Medicines should not be disposed of via wastewater or household
waste. Ask your pharmacist how to dispose of medicines no longer
required. These measures will help to protect the environment.

6. Further information
What Parnate contains

Each coated tablet contains tranylcypromine sulphate equivalent
to 10mg of tranylcypromine.
Parnate also contains the following inactive ingredients:
ƒ
Tablet core: sucrose, maize starch,
calcium sulphate dihydrate, carmellose sodium,
magnesium stearate (E572).
ƒ
Tablet coating: gelatine, sucrose, docusate sodium,
purified talc (E553b), light kaolin (E559),
calcium carbonate (E170), ethylcellulose, acacia (E414),
Carmoisine (E122), Ponceau 4R (E124), maize starch,
titanium dioxide (E171), carnauba wax (E903)
ƒ
Printing ink: shellac, black iron oxide (E172),
soya lecithin (E322) and trace amounts of dimethyl siloxane.

What Parnate looks like and contents of the pack
Parnate are geranium-red coloured, bi-convex, sugar-coated
tablets marked FW 251 on one face and plain on the reverse.
Parnate is available in white containers of 28 tablets.

Page 2 of 2

PACKAGE LEAFLET: INFORMATION FOR THE USER

TRANYLCYPROMINE 10MG COATED TABLETS

Tranylcypromine MUST NOT be taken with the
following medicines:
ƒ

(tranylcypromine sulphate)
Your medicine is available using the name Tranylcypromine 10mg
Coated Tablets but will be referred to as Tranylcypromine
throughout this leaflet.

Read all of this leaflet carefully before you start
taking this medicine.

Keep this leaflet. You may need to read it again. If you have any
further questions, ask your doctor or pharmacist. This medicine
has been prescribed for you. Do not pass it on to others.
It may harm them, even if their symptoms are the same as yours.
If any of the side effects become serious, or if you notice any side
effects not listed in this leaflet, please tell your doctor or
pharmacist.

ƒ
ƒ
ƒ
ƒ

ƒ
ƒ

In this leaflet:

1.
2.
3.
4.
5.
6.

What Tranylcypromine is and what it is used for
Before you take Tranylcypromine
How to take Tranylcypromine
Possible side effects
How to store Tranylcypromine
Further information

1. What Tranylcypromine is and what it is
used for
Tranylcypromine contains the active substance tranylcypromine
which belongs to a group of antidepressant medicines known as
monoamine oxidase inhibitors (MAOIs). It works by stopping the
breakdown of two substances in the brain called serotonin and
noradrenaline. Your medicine should help bring these substances
back to normal levels.
Tranylcypromine is used to treat moderate to severe depression.
It can also help feelings of fear (phobia) which sometimes occurs
in depression. This medicine is often used when other types of
antidepressant medicines have not worked.

2. Before you take Tranylcypromine
DO NOT take Tranylcypromine if:

You know that you are allergic to tranylcypromine or any of
the other ingredients of Tranylcypromine (see section 6 of
this leaflet).
ƒ
You are taking clomipramine, imipramine and venlafaxine.
ƒ
You suffer from porphyria which is an inherited disease
affecting the nervous system and skin.
ƒ
You have severe heart disease or any disease of the blood
vessels of the brain
ƒ
You have pheochromocytoma which is a tumour of the
adrenal glands (glands near the kidneys) causing high blood
pressure.
ƒ
You have known liver damage or a disorder affecting the
blood cells (your doctor will know).
ƒ
You are pregnant, trying to become pregnant or breastfeeding
ƒ
You are in a manic phase
ƒ
You are taking any of the medicines listed under “Do not
take” in the Taking Other Medicines section of this leaflet.
Please tell your doctor if any of the above applies to you.
ƒ

Take special care with Tranylcypromine and talk to
your doctor if you:

ƒ
are elderly
ƒ
have a mild heart problem which restricts your activity
ƒ
suffer from seizures/fits (epilepsy)
ƒ
suffer from diabetes mellitus (sugar diabetes)
ƒ
suffer from blood disorders
ƒ
taking diuretics (water tablets)
ƒ
are due to have surgery in the next few weeks
ƒ
have depression or suicidal thoughts
ƒ
suffer from low blood pressure or high blood pressure
ƒ
suffer from schizophrenia
ƒ
have a history of dependence on drugs or alcohol.
Even though some of the above may be obvious, it is important
that your doctor is aware if any of them apply to you.

Taking other medicines:

Please tell your doctor or pharmacist if you are taking or have
recently taken any other medicines, including medicines obtained
without a prescription.

ƒ

ƒ
ƒ
ƒ
ƒ
ƒ
ƒ
ƒ
ƒ
ƒ

Medicines called sympathomimetic agents - these include
ephedrine, pseudoephedrine, adrenaline and noradrenaline
(these may be found in medicines used to treat heart
problems and asthma as well as some decongestants and
cough/cold remedies e.g. dextromethorphan bought without
a prescription)
Bupropion, a medicine to help you stop smoking
Medicines for migraine e.g. 5HT1 agonists
Strong pain killers e.g. pethidine, morphine, codeine and
nefopam
It should not be administered at the same time as, or within
14 days of treatment with other MAOIs such as isocarboxid,
buspirone, or dibenzazepine derivative drugs (including
tricyclic antidepressant agents, perphenazine or
carbemazepine).
Medicines used to treat depression (e.g. clomipramine,
imipramine, venlafaxine)
Tranylcypromine should not be administered together with
clomipramine and imipramine. In the cases of clomipramine
and imipramine, 3 weeks should be left before starting
tranylcypromine therapy.
Tranylcypromine should not be administered in combination
with selective serotonin reuptake inhibitors (SSRIs) e.g.,
fluoxetine or serotonin/noradrenaline reuptake inhibitors
(SNRIs) e.g. venlafaxine. Therefore SSRIs and SNRIs should
not be used in combination with an MAOI, or within 14 days
of discontinuing therapy with an MAOI.
Buspirone, used to treat anxiety
Medicines to treat seizures/fits, e.g. carbamazepine
Perphenazine used to treat schizophrenia
Guanethidine used to treat high blood pressure
SSRIs such as fluoxetine, paroxetine or sertaline (for
depression)
Medicines like altretamine used for the treatment of cancer
Doxapram used to increase the rate of breathing, especially
during surgery
Medicines like oxypertin, clozapine used for the treatment of
mental disorders like schizophrenia
Tetrabenazine used for the treatment of excessive
restlessness.

Tranylcypromine 10mg Tablets must be taken with
caution if you are taking the following medicines:

Barbiturates used to treat severe sleeping problems, e.g.
amylobarbitone
ƒ
Medicines used to treat depression (e.g. amitriptyline,
imipramine, tryptophan, amfebutamone)
ƒ
Phenylpropanolamine used to treat nasal congestion
associate with allergies
ƒ
Medicines for high blood pressure (e.g. reserpine,
methyldopa)
ƒ
Medicines to control appetite, e.g. amphetamine and
fenfluramine
ƒ
Antimuscarinics for motion sickness, muscle cramps in the
gut or bladder
ƒ
Medicines that treat Parkinson’s disease, e.g. levodopa
ƒ
Dopamine, a medicine used to treat certain heart conditions
ƒ
Local anaesthetics e.g. lidocaine
ƒ
Medicines to treat diabetes (e.g. insulin, metformin).
At least 5 weeks should be allowed after stopping fluoxetine
before starting Tranylcypromine.
At least 2 weeks should be allowed after stopping paroxetine
before starting Tranylcypromine.
ƒ

Taking Tranylcypromine 10mg Tablets with food
and drink:

You should NOT take alcohol (especially red wine) whilst you are
taking Tranylcypromine. This includes non-alcoholic beer or lager.
Tranylcypromine stops the breakdown of a substance called
tyramine which is found in large amounts of certain foods. If this
substance is not broken down, it can cause very high blood
pressure. So, whilst you are taking Tranylcypromine, you should
avoid the following foods:
ƒ
Matured cheeses – cooked or plain (e.g. cheddar or
processed cheese made from mature cheese)
ƒ
Yeast extracts (e.g. Bovril, Oxo, brewer’s yeast or Marmite)
ƒ
Meat, fish or poultry which is not fresh or has been pickled
or aged e.g. hung game, pickled herrings
ƒ
Broad bean pods
ƒ
Flavoured textured vegetable protein
ƒ
Protein foods that are not fresh and whose preparation
involved hydrolysis, fermentation, pickling, hanging,
smoking or bacterial contamination e.g. dry sausage
(salami, pepperoni etc.), fermented soya bean extract, liver,
yoghurt
ƒ
Excessive amounts of chocolate
ƒ
Excessive amounts of tea or coffee.

Page 1 of 2

Pregnancy and breast-feeding

Please let the doctor know if you are pregnant, think you might be
pregnant, are planning to become pregnant or are breast-feeding.
Tranylcypromine should NOT be used during pregnancy or breast
feeding unless your doctor thinks it is essential. This medicine
may pass into breast milk.
Ask your doctor or pharmacist for advice before taking any
medicine.

Driving and using machines

Tranylcypromine may make you feel drowsy or dizzy or affect
your concentration. You should not drive or use machines when
you first start to take this medicine until you are certain that you
are not getting these side effects. If in any doubt, speak to your
doctor before you drive or use machines.

Important information about some of the
ingredients of Tranylcypromine

This medicine also contains carmoisine (E122) and Ponceau 4R
(E124) which may cause allergic reactions.
This medicine also contains sucrose (a sugar). If you have been
told by your doctor that you have an intolerance to some sugars,
contact your doctor before taking this medicine.

If you have an operation or you need to go to the
Dentist:

Tranylcypromine 10mg Tablets are not normally taken for two
weeks before an operation or major dentistry. Check with your
doctor or dentist and alert them to your medication.

3. How to take Tranylcypromine
Always take Tranylcypromine exactly as your doctor has told you.
Do NOT take more than your doctor tells you to. You should check
with your doctor or pharmacist if you are not sure.
Swallow the tablets whole with a glass of water.
USUAL DOSE (Adults only)
ƒ
One tablet in the morning and one tablet in the afternoon
each day.
ƒ
Try to take the last dose before 3 o’clock in the afternoon.
ƒ
This dose may be increased by your doctor to three tablets a
day. Take the extra tablet at midday.
ƒ
If you are elderly your doctor will usually prescribe you a
lower dose.
When you start to feel better, your doctor may change your dose
to one tablet a day.
Do NOT take more than three tablets each day unless your doctor
tells you.
Children: Tranylcypromine is not recommended for children
under 18 years old.

If you take more Tranylcypromine than you should:
If you think that you, or any other person, have taken too many
tablets, contact your doctor or hospital casualty department
immediately. Take any remaining tablets and this leaflet with you
so that the medical staff know exactly what you have taken.

If you forget to take your Tranylcypromine:

If you miss a dose, wait until your next dose. Do not take the
dose you have missed. You can then carry on as before. Do not
take more than one dose at a time.

If you stop taking Tranylcypromine

Continue to take Tranylcypromine even if you no longer feel ill.
DO NOT STOP taking this medicine without talking with your
doctor first, especially if you have taken large doses for a long
time. When the time comes to stop your doctor will probably
decrease your dose gradually as stopping the tablets suddenly
may cause ill-effects such as nausea (feeling sick), vomiting
(being sick), sweating, vivid nightmares, fits, worsening of
symptoms and difficulty in sleeping.
If you have any further questions on the use of this medicine, ask
your doctor or pharmacist.

4. Possible side effects
Like all medicines, Tranylcypromine can sometimes cause side
effects, although not everybody gets them. If you eat foods or
take medicines which interact with the active ingredient,
tranylcypromine, you may get very high blood pressure (a
hypertensive crisis).

If you notice any of the following symptoms please see your
doctor immediately.
ƒ
frequent headaches, shakiness, nervousness, excessive
happiness or excitement (euphoria), painful or stiff neck,
changes in heart rate, pain in the middle of the chest,
feeling sick or being sick, sweating, paleness, or flushing of
the skin and enlarged pupils which may make bright sunlight
uncomfortable, muscle twitching, muscle jerks, increased
reflexes, feeling nervous or uneasy. Although very rare,
muscle rigidity, fever and irregular body movements (i.e.
neuroleptic malignant syndrome), severe problems with the
heart and breathing, changes in the metabolism may occur,
feeling of a lump in the throat, increased muscular
movements, coma
ƒ
thought of suicide and suicidal behaviour early on in
treatment or shortly after stopping treatment.

If this occurs contact your doctor or go to a hospital
straight away.
Very rarely, liver problems (symptoms include yellowing of the
skin and the whites of the eyes), bruising and changes in blood
have been reported. Therefore, if you get a bad sore throat or
high fever or become very tired and pale or notice bruises and
nose bleeds, tell your doctor.
Sometimes patients feel anxious whilst taking this medicine and
rarely some patients will become very agitated or irritable. Your
doctor may reduce your dose if this happens.
Other side effects which may occur include:
ƒ
difficulty in sleeping, mild headache, sleepiness, weakness,
dizziness, fast or irregular heart beat (palpitations),
restlessness, dry mouth, inability to normally open mouth,
blurred vision, feeling sick, water retention or swelling,
difficulty in passing stools, other tummy problems,
swelling,increase in the level of liver enzymes on
examination, squint in the eyes, decrease in the blood cell
count in the body, sexual problems, confusion, reduced or
increased levels of salt in the body, repetition or echoing of
one's own spoken words, fits, glaucoma (increased pressure
in the eyes) itching, tingling or pricking of skin, altered
driving abilities, weight gain, increased appetite, rash, being
sick, diarrhoea, fatigue, hallucinations and difficulty in
passing water.

6. Further information
What Tranylcypromine contains

Each coated tablet contains tranylcypromine sulphate equivalent
to 10mg of tranylcypromine.
Tranylcypromine also contains the following inactive ingredients:
ƒ
Tablet core: sucrose, maize starch,
calcium sulphate dihydrate, carmellose sodium,
magnesium stearate (E572).
ƒ
Tablet coating: gelatine, sucrose, docusate sodium,
purified talc (E553b), light kaolin (E559),
calcium carbonate (E170), ethylcellulose, acacia (E414),
Carmoisine (E122), Ponceau 4R (E124), maize starch,
itanium dioxide (E171), carnauba wax (E903)
ƒ
Printing ink: shellac, black iron oxide (E172),
soya lecithin (E322) and trace amounts of dimethyl siloxane.

What Tranylcypromine looks like and contents of
the pack

Tranylcypromine are geranium-red coloured, bi-convex,
sugar-coated tablets marked FW 251 on one face and plain on the
reverse.
Tranylcypromine is available in white containers of 28 tablets.

Manufacturer

Manufactured by: Dales Pharmaceuticals Ltd., Snaygill Industrial
Estate, Keighley Road, Skipton, North Yorkshire, BD23 2RW.
Procured from within the EU and repackaged by: Doncaster
Pharmaceuticals Group Ltd., Kirk Sandall, Doncaster, DN3 1QR.
Product Licence holder: Landmark Pharma Ltd., 7 Regents Drive,
Prudhoe, Northumberland, NE42 6PX.
PL No: 21828/0496

POM

Leaflet revision and issue date: 12.11.13

Some patients get low blood pressure and may feel dizzy on
standing up. If this continues for a long time, your doctor may
stop your medicine.
Rarely some patients experience soreness in the hands and feet
which may be a sign of inflamed nerves, spasm of the axial
muscles.
If any of the side effects become serious, or if you notice
any side effects not listed in this leaflet, please tell your
doctor or pharmacist.
You may find it helpful to tell a relative or close friend that
you are depressed or have anxiety disorder, and to ask
them to read this leaflet. You might ask them to tell you if they
think your depression or anxiety is becoming worse or if they are
worried about changes in your behaviour.
Also you can help to make sure that medicines remain as safe as
possible by reporting any unwanted side effects via the internet at
www.mhra.gov.uk/yellowcard. Alternatively you can call
Freephone 0808 100 3352 (available from 10 a.m. to 2 p.m.
Mondays to Fridays) or fill in a paper form available from your
local pharmacy.

5. How to store Tranylcypromine
KEEP OUT OF THE SIGHT AND REACH OF CHILDREN.
Do not use Tranylcypromine after the expiry date which is stated
on the box. The expiry date refers to the last day of that month. If
your tablets are out of date, take them to your pharmacist who
will get rid of them safely.
Do not store above 25°C (normal room temperature).
Store in the original package and protect from light and moisture.
Keep container tightly closed.
If your tablets appear to be discoloured or show any other signs of
deterioration, take them to your pharmacist who will advise you.
If your doctor decides to stop treatment, return any leftover
tablets to the pharmacist. Only keep them if your doctor tells you
to.
Medicines should not be disposed of via wastewater or household
waste. Ask your pharmacist how to dispose of medicines no longer
required. These measures will help to protect the environment.

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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