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|Tranylcypromine sulfate Tranylcypromine Sulfate

Tranylcypromine sulfate

Generic name: Tranylcypromine sulfate
Brand names: Parnate

Why is Tranylcypromine sulfate prescribed?

Tranylcypromine sulfate is prescribed for the treatment of major depression--that is, a depressed mood that lasts for at least 2 weeks and interferes with daily functioning. Major depression is marked by at least 4 of the following 8 symptoms: changes in appetite, changes in sleep patterns, agitation or listlessness, loss of interest in usual activities or a decrease in sex drive, fatigue, feelings of guilt or worthlessness, slowed thinking or difficulty concentrating, and thoughts of suicide.

Tranylcypromine sulfate is a member of the class of drugs known as monoamine oxidase (MAO) inhibitors. It works by increasing concentrations of the brain chemicals epinephrine, norepinephrine, and serotonin.

Most important fact about Tranylcypromine sulfate

Tranylcypromine sulfate is a potent drug with the capability of producing serious side effects. It is typically prescribed only if other antidepressants fail, and then only for adults who are under close medical supervision. It is considered especially risky because it can interact with a long list of drugs and foods to produce life-threatening side effects (see "Possible food and drug interactions when taking Tranylcypromine sulfate").

How should you take Tranylcypromine sulfate?

Your doctor will adjust the dosage of Tranylcypromine sulfate according to your individual needs and response. The drug usually produces improvement within 48 hours to 3 weeks after starting therapy.

--If you miss a dose...

Take it as soon as you remember. If it is within 2 hours of your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at once.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Tranylcypromine sulfate.

• More common side effects may include:
  Blood disorders, diarrhea, dizziness, drowsiness, dry mouth, insomnia, muscle spasm, nausea, overstimulation, rapid or irregular heartbeat, restlessness, ringing in the ears, water retention, weakness, weight loss

Why should Tranylcypromine sulfate not be prescribed?

Do not take Tranylcypromine sulfate if you are in danger of a stroke, if you have heart or liver disease, high blood pressure, or a history of headaches, if you have a type of tumor known as pheochromocytoma, or if you will be undergoing elective surgery requiring general anesthesia.

Special warnings about Tranylcypromine sulfate

In clinical studies, antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Tranylcypromine sulfate or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Tranylcypromine sulfate is not approved for use in children.

Additionally, the progression of major depression is associated with a worsening of symptoms and/or the emergence of suicidal thinking or behavior in both adults and children, whether or not they are taking antidepressants. Individuals being treated with Tranylcypromine sulfate and their caregivers should watch for any change in symptoms or any new symptoms that appear suddenly--especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior--and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose.

The most dangerous reaction to Tranylcypromine sulfate is a surge in blood pressure, which has sometimes been fatal. For this reason, report promptly to your doctor any of the following symptoms: constriction or pain in the throat or chest, dizziness, fever, headache, irregular heartbeat, light sensitivity, nausea, neck stiffness or soreness, palpitations, pupil dilation, sweating, or vomiting.

A number of people who take Tranylcypromine sulfate experience low blood pressure, faintness, or drowsiness, so exercise great care when performing potentially hazardous tasks, such as driving a car or operating machinery.

Some people become physically dependent on Tranylcypromine sulfate and experience withdrawal symptoms when the drug is stopped, including restlessness, anxiety, depression, confusion, hallucinations, headache, weakness, and diarrhea.

If you have kidney problems, make sure the doctor is aware of this. The doctor may need to reduce your dosage of Tranylcypromine sulfate to avoid a buildup of the drug. Tranylcypromine sulfate should also be used with caution if you have an overactive thyroid gland.

MAO inhibitors can suppress heart pain that would otherwise serve as a warning sign of a heart attack. For this reason and others, it should be used with caution by older adults. Also, it should be used with caution by diabetics and people with epilepsy or other convulsive disorders because it can alter the level of drugs used to treat these conditions. Tell every doctor or dentist who you see that you are taking Tranylcypromine sulfate.

Possible food and drug interactions when taking Tranylcypromine sulfate

Never take Tranylcypromine sulfate with the following drugs; the combination can trigger seizures or a dangerous spike in blood pressure:

Other MAO inhibitors such as Nardil
Antidepressant drugs classified as tricyclics, such as Anafranil, Elavil, and Tofranil
Carbamazepine (Tegretol)
Cyclobenzaprine (Flexeril)

When switching from one of these drugs to Tranylcypromine sulfate, or vice versa, allow an interval of at least 1 week between medications.

Also avoid combining Tranylcypromine sulfate with any of the following:

Antidepressant drugs classified as selective serotonin reuptake inhibitors, such as Paxil, Prozac, and Zoloft
Amphetamines such as Adderall and Dexedrine
Anesthetics
Antihistamines such as Allegra, Benadryl, and Clarinex
Blood pressure medications such as Accupril, Lotensin, and Prinivil
Bupropion (Wellbutrin)
Buspirone (BuSpar)
Cold and hay fever remedies that constrict blood vessels
Cough remedies containing dextromethorphan
Demerol and other narcotic painkillers such as Percodan, OxyContin, and Vicodin
Disulfiram (Antabuse)
Guanethidine
Methyldopa
Over-the-counter weight reduction aids
Parkinson"s disease medications such as Parlodel, Requip, and Sinemet
Reserpine
Sedatives such as Halcion, Nembutal, and Seconal
Tryptophan
Water pills such as HydroDIURIL

While taking Tranylcypromine sulfate, you should also avoid foods that contain a high amount of a substance called tyramine, including:

Anchovies
Avocados
Bananas
Beer (including nonalcoholic beer)
Caviar
Cheese (especially strong and aged varieties)
Chianti wine
Chocolate
Dried fruits (including raisins, prunes, and figs)
Liqueurs
Liver
Meat extracts or meat prepared with tenderizers
Overripe fruit
Pickled herring
Pods of broad beans like fava beans
Raspberries
Sauerkraut
Sherry
Sour cream
Soy sauce
Yeast extracts
Yogurt

Likewise, avoid alcohol and large amounts of caffeine.

Special information if you are pregnant or breastfeeding

If you are pregnant or plan to become pregnant, inform your doctor immediately. Tranylcypromine sulfate should be used during pregnancy only if its benefits outweigh potential risks.

Tranylcypromine sulfate makes its way into breast milk. If the drug is essential to your health, your doctor may advise you to stop nursing until your treatment is finished.

Recommended dosage

ADULTS

The usual dosage is 30 milligrams per day, divided into smaller doses. If ineffective, the dosage may be slowly increased under your doctor"s supervision to a maximum of 60 milligrams per day.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose of Tranylcypromine sulfate, seek medical help immediately.

• Symptoms of Tranylcypromine sulfate overdose may include:
  Agitation, confusion, coma, dizziness, drowsiness, high fever, incoherence, rigid muscles, severe headache, twitching, weakness