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Package leaflet: Information for the patient
Parnate® 10mg Tablets
Read all of this leaflet carefully before you start taking this medicine because it contains important
information for you.
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 signs of illness are the same as yours.
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not
listed in this leaflet.
Parnate ® 10mg Tablets will be referred to as Parnate throughout this leaflet.

What is in this leaflet:
1. What Parnate are and what they are used for
2. What you need to know before you take Parnate
3. How to take Parnate
4. Possible side effects
5. How to store Parnate
6. Contents of the pack and other information
1. What Parnate are and what they are used for
Parnate contain 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.
This medicine is used to treat moderate to severe depression. It can also help you if you are having
feelings of fear (phobia) which sometimes occurs in depression. This medicine is often used when other
types of antidepressant medicines have not worked.
2. What you need to know before you take Parnate
Do not take Parnate if:
• You are allergic to tranylcypromine or any of the other ingredients of this medicine (listed in section 6).
• You are taking clomipramine, imipramine and venlafaxine. You should wait three weeks before starting
trancylpromine after stopping treatment with clomipramine, imipramine and venlafaxine.
• You suffer from porphyria which is an inherited disease affecting the nervous system and skin
• You have severe heart disease or any disease of the blood vessels of the brain
• You have pheochromocytoma which is a tumour of the adrenal glands (glands near the kidneys) causing
high blood pressure
• You have known liver damage or a disorder affecting the blood cells (your doctor will know)
• You are pregnant, trying to become pregnant or breast-feeding.
• You suffer from a mental health disorder and are in a manic phase.
• You are taking any of the medicines listed under Other Medicines and Parnate.

You should also avoid certain drugs called guanethidine (used for high blood pressure),
dextromethorphan (cough suppressant), alcohol or narcotic analgesics or pain killers (morphine or

Warnings and precautions
Talk to your doctor or pharmacist before taking this medicine if you:
• are elderly
• have a mild heart problem which restricts your activity
• suffer from seizures/fits (epilepsy)
• suffer from diabetes mellitus (sugar diabetes)
• suffer from blood disorders
• taking diuretics (water tablets)
• are due to have surgery in the next few weeks (including dental surgery)
• have depression, feeling low or have suicidal thoughts
• suffer from low blood pressure or high blood pressure
• suffer from schizophrenia
• 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.
If you are depressed and/or have anxiety disorders, you can sometimes have thoughts of harming or
killing yourself (see section 4 ‘Possible side effects’). These may be increased when first starting
antidepressants, since these medicines all take time to work, usually about two weeks but sometimes
You may be more likely to think like this if you:
• have previously had thoughts about killing or harming yourself.
• are a young adult.
If you have thoughts of harming or killing yourself, at any time, contact your doctor or go to a hospital
straight away. You may find it helpful to tell a relative or close friend that you are depressed or have an
anxiety disorder, and ask them to read this leaflet. You might ask them to tell you if they think your
depression or anxiety is getting worse, or if they are worried about changes in your behavior.
Children and adolescents
Tranylcypromine is not recommended for children under 18 years old (see section 3 ‘Use in children and
Other medicines and Parnate
Tell your doctor or pharmacist if you are taking or have recently taken any other medicines.
Parnate MUST NOT be taken with the following medicines:
• 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
• 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.
• 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 must be taken with caution if you are taking the following medicines:
• Barbiturates used to treat severe sleeping problems, e.g. amylobarbitone
• Medicines used to treat depression (e.g. amitriptyline, imipramine, tryptophan, amfebutamone)
• Phenylpropanolamine used to treat nasal congestion associate with allergies
• Medicines for high blood pressure (e.g. reserpine, methyldopa)
• Medicines to control appetite, e.g. amphetamine and fenfluramine
• Antimuscarinics for motion sickness, muscle cramps in the gut or bladder
• Medicines that treat Parkinson’s disease, e.g. levodopa
• Dopamine, a medicine used to treat certain heart conditions
• Local anaesthetics e.g. lidocaine
• 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.
Taking Parnate with food and drink
You should NOT take alcohol (especially red wine) whilst you are taking Parnate. This includes nonalcoholic 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:
• Matured cheeses – cooked or plain (e.g. cheddar or processed cheese made from mature cheese)
•Yeast extracts (e.g. Bovril, Oxo, brewer’s yeast or Marmite)
• Meat, fish or poultry which is not fresh or has been pickled or aged e.g. hung game, pickled herrings
• Broad bean pods
• Flavored textured vegetable protein

• 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
• Excessive amounts of chocolate
• Excessive amounts of tea or coffee.
Pregnancy and breast feeding
If you are pregnant or breast-feeding, think you may be pregnant or planning to have a baby, ask your
doctor or pharmacist for advice before taking this medicine.
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.
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
Important information about some of the ingredients of Parnate
This medicine also contains carmoisine (E122) and Ponceau 4R (E124) which may cause allergic
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 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 this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if
you are not sure.
Swallow the tablets whole with a glass of water.
The recommended dose for adults is:
• One tablet in the morning and one tablet in the afternoon each day
• Try to take the last dose before 3 o’clock in the afternoon
• This dose may be increased by your doctor to three tablets a day. Take the extra tablet at mid-day
• 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.
Use in children and adolescents
Tranylcypromine Tablets are 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 have accidently taken a very large dose than what has been prescribed for you, you may experience
euphoria and feeling over excited followed by a coma with low blood pressure or extremely high blood
pressure with bleeding in your brain.
You may experience drowsiness, nausea (feeling sick), vomiting (being sick), start seeing or feelings
things that do not exist, headache, clammy skin, fainting, fits or tiredness.
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. Symptoms will usually start 24 to 72
hours after you stop taking this medicine abruptly.
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, tranylcypromine, you may get
very high blood pressure (a hypertensive crisis).
Very common: may affect more than 1 in 10 people
Common: may affect up to 1 in 10 people
Uncommon: may affect up to 1 in 100 people
Rare: may affect up to 1 in 1,000 people
Very rare: may affect up to 1 in 10,000 people
Not known: frequency cannot be estimated from the available data
If you notice any of the following symptoms please stop taking your medicine and see your doctor
• Although very rare, muscle rigidity, fever and irregular body movements (i.e. neuroleptic malignant
• Severe problems with the heart and breathing, feeling of a lump in the throat, increased muscular
movements, thought of suicide and suicidal behavior early on in treatment or shortly after stopping
• You may being seeing, hearing, smelling, tasting or feeling things that don't exist outside their mind or
have disorganized speech (signs of a condition called schizophrenia) (Rare)

• You may experience fatigue, weakness, shortness of breath, fever or you may bleed or bruise easily
indicating you may have a blood disorder (uncommon).
• You may experience liver problems (symptoms include yellowing of the skin and the whites of the
eyes). You may get a sore throat or high fever or become very tired and pale or notice bruises and nose
• You may experience lupus-like syndrome seen as joint pain, swelling, and rashes on face, wrists, hands
or maybe extreme tiredness (uncommon).
Additional side effects:
• Blurred vision
• Nausea (feeling sick)
• Vomiting (being sick)
• Dry mouth
• Constipation (difficulty in passing stools)
• Tiredness
• Increase in the level of liver enzymes on examination
• Dizziness
• Overactive or overresponsive reflexes
• Uncontrollable movements of mouth, tongue and limbs
• Difficulty sleeping
• Difficulty in reaching an orgasm (only in women)
• Altered driving ability
• A fall in blood pressure on standing up which causes dizziness, light-headedness or fainting
• Muscle twitching or jerking
• Purplish discoloring of the skin
• Itching, tingling or pricking of skin,
• Rash
• Nervousness
• Excessive happiness or excitement (euphoria),
• Confusion
• Difficulty in passing water
• Inability to maintain erection
• Glaucoma (increased pressure in the eyes)
• Irregular heart beat
• Weight gain
• Increased appetite
• Increased levels of salt in the body
• Fits
• Involuntary eye movements
• Changes in the metabolism may occur
• Sweating
• Feeling jittery
• Repetition or echoing of one's own spoken words
• Shakiness
• Headache

Difficulty in controlling movements


Not known:
• Water retention or swelling
• Flushing
• Agitation
• Irritable
• Painful or stiff neck
• Pain in the middle of the chest
Rarely some patients experience soreness in the hands and feet which may be a sign of inflamed
nerves,spasm of the axial muscles.
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 behavior.
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects
not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme
5. How to store Parnate
Keep this medicine 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.
6. Contents of the pack and other information
Each tablet contains 10mg of the active substance, tranylcypromine.
Parnate also contains sucrose, maize starch, calcium sulphate dehydrate (E516),carmellose sodium,
magnesium stearate (E470b). The coating contains 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) and edible ink.
What Parnate look like and contents of the pack
Parnate are bi-convex, red coated tablets marked with SKF and/or FW 251 on one side.
They are packed in plastic containers with 28 and 250 tablets. Not all pack sizes may be marketed.
Marketing Authorisation Holder
Mercury Pharma Ltd.,
Capital House,
85 King William Street,
London EC4N 7BL,
Dales Pharmaceuticals Ltd.,

Snaygill Industrial Estate, Keighley Road, Skipton, North Yorkshire, BD23 2RW, UK
This leaflet was last revised in December 2014.

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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.