Tranylcypromine - oral
Tranylcypromine - oral
Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.
Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.
This drug may rarely cause an attack of extremely high blood pressure (hypertensive crisis), which may be fatal. Many drug interactions can increase this risk. Food and drinks that contain tyramine can also increase this risk. See also Side Effects and Drug Interactions sections. Check your blood pressure regularly. Tell your doctor and pharmacist about all prescription/nonprescription drugs and herbal products you take before starting tranylcypromine. Ask them before starting any other drugs while taking tranylcypromine, and even when you stop taking tranylcypromine since it can still cause these interactions for a period of time.
Tranylcypromine is an antidepressant (monoamine oxidase inhibitor). This medication treats depression by restoring the balance of certain natural substances (neurotransmitters) in the brain. Tranylcypromine can improve your mood and feelings of well-being. Usually, this medication is used in persons who have not responded to treatment with other drugs.
Read the Medication Guide available from your pharmacist before you start using tranylcypromine and each time you get a refill. If you have any questions, consult your doctor or pharmacist.
Take this medication by mouth, usually in divided doses or as directed by your doctor. This medication may be taken with or without food. Dosage is based on your medical condition and response to therapy and usually will not be more than 60 milligrams per day.
To reduce your risk of side effects, your doctor may start you at a low dose and gradually increase your dose. Once your condition improves and you are better for a while, your doctor may work with you to reduce your regular dose. Follow your doctor's instructions carefully. Do not take more or less medication or take it more frequently than prescribed. Your condition will not improve any faster and your risk of side effects will increase.
Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day. It may take several weeks for the full benefits of this medication to be noticed. Do not stop taking this medication without consulting your doctor.
If you suddenly stop using this medication, you may have withdrawal symptoms (such as restlessness, confusion, hallucinations, headache, weakness, and diarrhea). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used tranylcypromine for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.
Inform your doctor if your condition persists or worsens.
See also Warning section.
Dizziness, drowsiness, tiredness, weakness, problems sleeping, constipation, and dry mouth may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.
To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
Tell your doctor right away if any of these unlikely but serious side effects occur:
Tell your doctor right away if any of these highly unlikely but very serious side effects occur:
Stop taking tranylcypromine and get medical help right away if any of these symptoms of extremely high blood pressure (hypertensive crisis) occur:
This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms:
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include:
In the US -
Before taking tranylcypromine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of:
Before having surgery or any procedures requiring use of contrast dye (e.g., myelography), tell your doctor or dentist you are on this medication. You may need to stop taking this drug beforehand. Follow your doctor's instructions carefully.
If you have heart disease, this medication may mask chest pain. Avoid strenuous exercise while taking this medication.
If you have diabetes, tranylcypromine may lower your blood sugar. Check your blood sugar regularly and share the results with your doctor. Tell your doctor right away if you have symptoms of low blood sugar such as sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. Your doctor may need to adjust your diabetes medication, exercise program, or diet.
Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug, especially the effects on blood pressure.
This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.
Since untreated mental/mood problems (such as depression) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.
This medication passes into breast milk. Consult your doctor before breast-feeding.
Some products that may interact with this drug include:
The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/ "ecstasy," St. John's wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), meperidine, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.
Tell your doctor or pharmacist if you are using any of these medications before, during, or within 2 weeks after treatment with tranylcypromine. Tell your doctor or pharmacist if you have taken fluoxetine during at least 5 weeks before starting tranylcypromine. Discuss with your doctor how much time to wait between starting or stopping any of these drugs and taking tranylcypromine.
Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).
Check the labels on all your medicines (such as allergy, cough-and-cold products, diet pills) because they may contain dextromethorphan, decongestants, stimulants, or ingredients that cause drowsiness. Ask your pharmacist about the safe use of those products.
It is very important that you follow special dietary restrictions in order to limit the amount of tyramine in your diet. Avoid drinking large amounts of beverages containing caffeine (coffee, tea, colas) or eating large amounts of chocolate. Caffeine can increase the side effects of this medication. Foods and beverages high in tyramine should be avoided while you are taking this medication and for at least 2 weeks after you stop using this medication.
Foods high in tyramine include: aged cheeses (cheddar, camembert, emmenthaler, brie, stilton blue, gruyere, gouda, brick, bleu, roquefort, boursault, parmesan, romano, provolone, liederdranz, colby, edam), aged/dried/fermented/salted/smoked/pickled/processed meats and fish (includes bacon, summer sausage, liverwurst, hot dogs, corned beef, pepperoni, salami, bologna, ham, mortadella, pickled or dried herring), banana peel, beef/chicken liver (stored, not fresh), bouillon cubes, commercial gravies, concentrated yeast extracts, fava beans, Italian green beans, broad beans, fermented bean curd, homemade yeast-leavened bread, kim chee (Korean fermented cabbage), orange pulp, overripe or spoiled fruits, packaged soups, red wine, sauerkraut, sherry, snow pea pods, sourdough bread, soy sauce, soybeans, soybean paste/miso, tofu, tap beer and ale, vermouth.
Moderate-to-low tyramine content foods include: alcohol-free beer, avocados, bananas, bottled beer and ale, chocolate and products made with chocolate, coffee, cola, cultured dairy products (such as buttermilk, yogurt, sour cream), distilled spirits, eggplant, canned figs, fish roe (caviar), green bean pods, pate, peanuts, port wine, raisins, raspberries, red plums, spinach, tomatoes, white wine.
Tell your doctor or pharmacist right away if you notice symptoms of high blood pressure such as fast/slow heartbeat, vomiting, sweating, headache, chest pain, sudden vision changes, weakness on one side of the body, or slurred speech.
Contact your healthcare professionals (e.g., doctor, pharmacist, dietician) for more information, including recommendations for your diet.
Do not share this medication with others.
Laboratory and/or medical tests (e.g., blood pressure, liver function) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
If you miss a dose, take as soon as you remember unless the next scheduled dose is within 2 hours. In that case, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.
Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised March 2019.
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