Monograph Details
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Central Nervous System
> Mood disorders
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MARPLAN |
| Manufacturer |
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Validus Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Monoamine oxidase inhibitor (MAOI). |
| Generic Name |
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Isocarboxazid 10mg; scored tabs. |
| Indications |
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Refractory depression. |
| Children |
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<16yrs: Not recommended. |
| Adults |
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Initially 10mg twice daily. May increase by 10mg every 2–4 days up to 40mg daily. If tolerated, may increase by 20mg/week to max 60mg/day divided into 2–4 doses. |
| Contraindications |
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See Interactions. Pheochromocytoma. Cardiovascular, cerebrovascular, or liver disease. Hypertension. Chronic headache. To avoid potentially severe or fatal interactions, allow sufficient drug-free interval (see literature) between isocarboxazid and: sympathomimetics (eg, amphetamines, pseudoephedrine), tricyclic antidepressants (eg, amitriptyline, clomipramine), SSRIs or other neurotransmitter reuptake inhibitors (eg, fluoxetine), maprotiline, CNS depressants (eg, alcohol, barbiturates, narcotics), antihistamines, antihypertensives (eg, guanethidine), anesthetics, bupropion, buspirone, carbamazepine, cyclobenzaprine, dibenzazepines, diuretics, dextromethorphan, dopamine, other MAOIs (eg, phenelzine, selegiline, furazolidone, tranylcypromine), levodopa, methyldopa, methylphenidate, phenylalanine, tryptophan-, dopamine-, tyrosine-, or tyramine-containing foods, excess caffeine or chocolate. Meperidine within 3 weeks of isocarboxazid. |
| Precautions |
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Hypotension. Suicidal tendencies. Psychosis. Mania/hypomania. Epilepsy. Hyperthyroidism. Surgery. Schizophrenia. Discontinue if palpitations or headache occurs, 48 hrs before to 24 hrs after myelography, or at 1st sign of jaundice or hepatic dysfunction. Avoid abrupt cessation. Monitor BP and observe patient frequently. May mask anginal pain or aggravate anxiety or agitation. Renal impairment. Elderly. Debilitated. Pregnancy. Nursing mothers: not recommended. |
| Interactions |
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See Contraindications. Hypertensive crises with sympathomimetics, levodopa, and high-tyramine foods (eg, cheese, salami, chocolate, wine, beer, pickled herring, chicken livers, yeast extract, yogurt, broad beans). Caution with antidiabetic agents, antiparkinson agents, disulfiram. Potentiates CNS depressants, antihypertensives. Psychosis with dextromethorphan. Circulatory collapse, coma, death with meperidine. Do not start within 5 wks of fluoxetine, 10 days of buspirone, or 2 wks of sertraline, paroxetine, bupropion or citalopram, or 1 wk of venlafaxine discontinuance. |
| Adverse Reactions |
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Orthostatic hypotension, hypertensive crises, dizziness, headache, dry mouth, GI disturbances, blurred vision, akathisia, ataxia, black tongue, coma, dysuria, euphoria, hematologic changes, incontinence, photosensitivity, seizures, changes in blood sugar. |
| How Supplied |
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Tabs—100 |
| Additional Resources |
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• Related Prescribing Note |
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