Drug Database - Tranylcypromine

Generic Name: tranylcypromine (tran-il-SIP-ro-meen)

Brand Names: Parnate®

Classification: Monoamine Oxidase Inhibitor (MOAI)

Issue Date: 1977

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 episode in adults. This medication is usually given after other anti-depressants have been tried without successful treatment of symptoms. Tranylcypromine will not treat bipolar disorder (manic depression).

There are many other medicines that can cause serious medical problems if you take them together with tranylcypromine. Do not take tranylcypromine before telling your doctor about all other prescription and over-the-counter medications you use, including :

• vitamins
• minerals
• herbal products

Keep a list with you of all the medicines you use and show this list to any doctor, dentist, or other healthcare provider who treats you.

You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. While you are taking this medication you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse:

• mood changes
• anxiety
• panic attacks
• trouble sleeping
• irritability
• agitation
• aggressiveness
• severe restlessness
• mania (mental and/ or physical hyperactivity)
• thoughts of suicide or hurting yourself

While you are taking tranylcypromine, you MUST NOT DRINK ALCOHOL OR EAT FOODS HIGH IN TYRAMINE. Eating tyramine while you are taking tranylcypromine can raise your blood pressure to dangerous levels, causing life-threatening symptoms such as:

• sudden and severe headache
• confusion
• blurred vision
• problems with speech or balance
• nausea
• vomiting
• chest pain
• seizure (convulsions)
• sudden numbness or weakness (especially on one side of the body)

Call your doctor at once if you have any of these symptoms.

You should become very familiar with the list of foods you must avoid while you are taking tranylcypromine.

Tranylcypromine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

DO NOT EAT FOODS HIGH IN TYRAMINE INCLUDING:

• air dried meats
• aged or fermented meats
• sausage or salami (including cacciatore and mortadella)
• pickled herring
• any spoiled or improperly stored beef, poultry, fish, or liver
• beer from a tap
• beer that has not been pasteurized
• aged cheeses including:
• blue
• boursault
• brick
• brie
• camembert
• cheddar
• emmenthaler
• gruyere
• parmesan
• romano
• roquefort
• stilton
• swiss
• over-the-counter supplements or cough and cold medicines containing tyramine
• sauerkraut
• soy beans
• soy sauce
• tofu
• miso soup
• bean curd
• fava beans
• yeast extracts (such as Marmite)

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the instructions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication. Take each dose with a full glass of water.

You may need to stop using the medicine for a short time if you need to have any type of surgery, or if you will have an x-ray, CT scan, or MRI of your spinal cord. Tell any doctor who treats you that you are taking tranylcypromine.

To be sure this medication is not causing harmful effects, your blood pressure will need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

Take this medication for the entire length of time prescribed by your doctor. It may take 4 weeks or longer before you notice improvement in your symptoms.

Do not use this medication if you have used another MAOI such as:

• isocarboxazid (Marplan®)
• phenelzine (Nardil®)
• rasagiline (Azilect®)
• selegiline (Eldepryl®, Emsam®)

within the past 14 days. Serious, life-threatening side effects can occur if you take tranylcypromine before another MAOI has cleared from your body. If you are switching to tranylcypromine from another MAOI, your doctor may start you at a low dose.

There are many other medicines that can cause serious medical problems if you take them together with tranylcypromine. The following drugs should not be used while you are taking tranylcypromine:

• amitriptyline (Elavil®, Etrafon®)
• amoxapine (Ascendin®)
• clomipramine (Anafranil®)
• desipramine (Norpramin®)
• imipramine (Janimine®, Tofranil®)
• nortriptyline (Pamelor®)
• protriptyline (Vivactil®)
• trimipramine (Surmontil®)
• citalopram (Celexa®)
• escitalopram (Lexapro®)
• fluoxetine (Prozac®, Sarafem®)
• fluvoxamine (Luvox®)
• paroxetine (Paxil®)
• sertraline (Zoloft®)
• guanethidine (Ismelin®)
• methyldopa (Aldomet®)
• reserpine
• diet pills
• stimulants
• ADHD medications
• over-the-counter cough and cold or allergy medicines
• doxepin (Adapin®, Sinequan®)
• carbamazepine (Carbatrol®, Tegretol®)
• cyclobenzaprine (Flexeril®)
• maprotiline (Ludiomil®)
• procarbazine (Matulane®)
• bupropion (Wellbutrin®, Zyban®)
• dexfenfluramine (Redux®)
• buspirone (BuSpar®)
• tryptophan (also called L-tryptophan®)
• levodopa (Larodopa®, Parcopa®, Sinemet®)
• meperidine (Demerol®, Mepergan®)

Before using this medication, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease, high blood pressure, circulation problems, or a history of stroke
• history of headaches (migraine, cluster, or other types)
• diabetes
• seizure disorder such as epilepsy

If you have any of these conditions, you may not be able to use tranylcypromine, or you may need a dosage adjustment or special tests during treatment.

You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. While you are taking tranylcypromine you will need to be monitored for worsening symptoms of depression and/or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse:

• mood changes
• anxiety
• panic attacks
• trouble sleeping
• irritability
• agitation
• aggressiveness
• severe restlessness
• mania (mental and/ or physical hyperactivity)
• thoughts of suicide or hurting yourself

This medication may be habit-forming. You may have withdrawal symptoms such as:

• anxiety
• confusion
• headache
• weakness
• depression
• hallucinations

when you stop using tranylcypromine after using it over a long period of time. Do not stop using this medication suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Tranylcypromine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more likely to have side effects from tranylcypromine. Tranylcypromine should not be given to a child without a doctor's advice.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction:

• skin rash or hives
• difficulty breathing
• swelling of your face, lips, tongue, or throat

Stop using tranylcypromine and call your doctor at once if you have any of these serious side effects:

• frequent headaches, vision problems, sensitivity to light
• fast or pounding heart beats, tight feeling in your chest or throat
• swelling of your ankles or feet
• pale skin, easy bruising or bleeding, unusual weakness
• nausea, vomiting, dizziness, sweating, stiffness in your neck
• confusion, lack of coordination, feeling light-headed, fainting
• tremors, muscle twitches you cannot control

Continue taking this medication and talk to your doctor if you have any of these less serious side effects:

• feeling restless, anxious, or agitated
• feeling weak or drowsy
• sleep problems (insomnia)
• nausea, diarrhea or constipation, loss of appetite, stomach pain
• chills, numbness or tingly feeling
• dry mouth, decreased urination
• blurred vision, ringing in your ears
• impotence, difficulty having an orgasm

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

There are many other medicines that can cause serious medical problems if you take them together with tranylcypromine. Do not take tranylcypromine before telling your doctor about all other prescription and over-the-counter medications you use. This includes:

• vitamins
• minerals
• herbal products
• drugs prescribed by other doctors
• amitriptyline (Elavil®, Etrafon®)
• amoxapine (Ascendin®)
• clomipramine (Anafranil®)
• desipramine (Norpramin®)
• imipramine (Janimine®, Tofranil®)
• nortriptyline (Pamelor®)
• protriptyline (Vivactil®)
• trimipramine (Surmontil®)
• citalopram (Celexa®)
• escitalopram (Lexapro®)
• fluoxetine (Prozac®, Sarafem®)
• fluvoxamine (Luvox®)
• paroxetine (Paxil®)
• sertraline (Zoloft®)
• guanethidine (Ismelin®)
• methyldopa (Aldomet®)
• reserpine
• diet pills
• stimulants
• ADHD medications
• over-the-counter cough and cold or allergy medicines
• doxepin (Adapin®, Sinequan®)
• carbamazepine (Carbatrol®, Tegretol®)
• cyclobenzaprine (Flexeril®)
• maprotiline (Ludiomil®)
• procarbazine (Matulane®)
• bupropion (Wellbutrin®, Zyban®)
• dexfenfluramine (Redux®)
• buspirone (BuSpar®)
• tryptophan (also called L-tryptophan®)
• levodopa (Larodopa®, Parcopa®, Sinemet®)
• meperidine (Demerol®, Mepergan®)

There may be other drugs not listed that can affect tranylcypromine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.