What is tranylcypromine?
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).
Tranylcypromine may also be used for other purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking tranylcypromine?
Do not use this medication if you have used another MAOI such as isocarboxazid
(Marplan), phenelzine (Nardil), rasagiline (Azilect), or 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:
-
an antidepressant;
-
blood pressure medicine such as guanethidine (Ismelin),
methyldopa (Aldomet), and 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);
-
venlafaxine (Effexor);
-
buspirone (BuSpar);
-
tryptophan (also called L-tryptophan);
-
levodopa (Larodopa, Parcopa, Sinemet); or
-
meperidine (Demerol, Mepergan).
If you have any of these other conditions, you may need a dose adjustment
or special tests to safely take tranylcypromine:
-
heart disease, high blood pressure, circulation problems, or a
history of stroke;
-
a history of headaches (migraine, cluster, or other types);
-
diabetes; or
-
a seizure disorder such as epilepsy.
You may have thoughts about suicide when you first start taking an
antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening
symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever
your dose is changed.
Your family or other caregivers should also 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.
This medication may be habit-forming. You may have withdrawal symptoms such as
anxiety, confusion, headache, weakness, depression, or 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.
FDA pregnancy category C. It is not known whether this medication is harmful to an
unborn baby. Before you take tranylcypromine, 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.
Do not give tranylcypromine to anyone younger than 18 years old without the advice of a
doctor.
How should I take tranylcypromine?
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.
Store tranylcypromine at room temperature away from moisture and heat.
What happens if I miss a dose of tranylcypromine?
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.
Where can I get more information about tranylcypromine?
Your pharmacist has information about tranylcypromine written for health professionals that you may read.
What are the possible side effects of tranylcypromine?
Get emergency medical help if you have any of these
signs of an allergic
reaction:
hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any new or worsening symptoms such as: mood or
behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated,
hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts
about suicide or hurting yourself.
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; or
-
tremors, muscle twitches you cannot control.
Less serious side effects may include:
-
feeling restless, weak, or drowsy;
-
nausea, diarrhea or constipation, loss of appetite, stomach
pain;
-
chills, numbness or tingly feeling;
-
dry mouth, decreased urination;
-
blurred vision, ringing in your ears; or
-
impotence, difficulty having an orgasm.
This is not a complete list of side effects and others may occur. Call your
doctor for medical advice about side effects. You may report side effects to FDA at
1-800-FDA-1088.
What is the most important information I should know about tranylcypromine?
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, and 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 thoughts about suicide when you first start taking an antidepressant, especially if
you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the
first 12 weeks of treatment.
Call your doctor at once if you have any new or worsening symptoms such as: mood or
behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated,
hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts
about suicide or hurting yourself.
While you are taking tranylcypromine, you must not drink alcohol or eat foods that are high
in tyramine, listed in the "What should I avoid while taking tranylcypromine?" section of this leaflet.
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), and 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.
What should I avoid while taking tranylcypromine?
While you are taking tranylcypromine, you must not eat foods that are high in tyramine,
including:
-
avocados, bananas, figs, raisins, and sauerkraut;
-
beef or chicken liver, fish, meats prepared with tenderizer,
bologna, pepperoni, salami, summer sausage, game meat, meat extracts, caviar, dried fish,
herring, and shrimp paste;
-
beer (alcoholic and nonalcoholic), red wine (especially
Chianti), sherry, vermouth, and other distilled spirits;
-
caffeine (including coffee, tea, cola); and
-
cheeses, including American, blue, boursault, brick, brie,
camembert, cheddar, emmenthaler, gruyere, mozzarella, parmesan, romano, roquefort, stilton,
and Swiss;
-
chocolate;
-
ginseng;
-
sour cream and yogurt;
-
soy sauce, miso soup, bean curd, fava beans; or
-
yeast extracts.
Eating tyramine while you are taking tranylcypromine can
raise your blood pressure to dangerous levels,
causing life-threatening side effects.
Avoid drinking alcohol or using other medicines that make you sleepy (such as cold
medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They
can worsen the low blood pressure caused by 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.
What other drugs will affect tranylcypromine?
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, and drugs prescribed by other doctors. Do not start
using a new medication without telling your doctor. 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.
What happens if I have an overdose of tranylcypromine?
