Monograph Details
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Central Nervous System
> Mood disorders
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PARNATE |
| Manufacturer |
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GlaxoSmithKline Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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MAOI. |
| Generic Name |
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Tranylcypromine (as sulfate) 10mg; tabs. |
| Indications |
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Refractory depression. |
| Children |
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Consult manufacturer. |
| Adults |
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30mg daily in divided doses. If no improvement after 2 wks, may increase in 10mg/day increments every 1–3 wks; usual max 60mg/day. |
| 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 tranylcypromine and: sympathomimetics (eg, amphetamines, pseudoephedrine), tricyclic antidepressants (eg, amitriptyline, clomipramine), SSRIs or other neurotransmitter reuptake inhibitors (eg, fluoxetine), maprotiline, mirtazapine, 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, isocarboxazid), levodopa, methyldopa, methylphenidate, tryptophan, phenylalanine, tryptophan-, dopamine-, tyrosine-, or tyramine-containing foods, excess caffeine or chocolate. Meperidine within 3 weeks of tranylcypromine. |
| Precautions |
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Hypotension. Suicidal tendencies. Psychosis. Mania/hypomania. Epilepsy. Hyperthyroidism. Surgery. Discontinue if palpitations or headache occurs and 48 hrs before to 24 hrs after myelography. 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. |
| 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, 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, headache, CNS overstimulation, seizures, changes in blood sugar, drowsiness, dry mouth, GI disturbances, tachycardia, anorexia, impotence, rash, hepatitis, edema. |
| How Supplied |
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Tabs—100 |
| Additional Resources |
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• Related Prescribing Note |
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