Tranylcypromine (tran-il-SIP-roe-meen)

Treats depression. This medicine is an MAOI.

Brand Name(s):

Parnate

When This Medicine Should Not Be Used:

How to Use This Medicine:

Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• You may need to use this medicine for up to 3 weeks before you start feeling better.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• You must avoid many other medicines while you are using tranylcypromine. These medicines, when used together could cause serious health problems, including death. Ask your doctor before you use any other medicine. You may need to wait 1 to 5 weeks before you can use the other medicine.
• Do not use this medicine if you have used another MAO inhibitor within the past 14 days. Do not take an MAO inhibitor for at least 7 days after you stop this medicine.
• Do not use this medicine if you are also using any of the following:
  • Buspirone, carbamazepine, cyclobenzaprine, dopamine, levodopa, methyldopa, milnacipran, rasagiline, reserpine, St John's wort, tapentadol, tetrabenazine
  • Blood pressure medicine
  • Cough and cold medicine (including dextromethorphan, ephedrine, phenylephrine, phenylpropanolamine, pseudoephedrine)
  • Medicine to treat depression (including bupropion, SNRI, SSRI, TCA)
  • Narcotic medicine (including meperidine, methadone)
• Some other medicines that may affect how tranylcypromine works include altretamine, chlorpromazine, droperidol, entacapone, fentanyl, lithium, metoclopramide, oxcarbazepine, tolcapone, tramadol, or diabetes medicine.
• Do not drink alcohol while you are using this medicine. Limit how much caffeine you drink or eat.
• Avoid foods and drinks that are high in tyramine, because your blood pressure could get dangerously high. Your doctor should give you a complete list. In general, do not eat anything aged or fermented, such as most cheese, most alcohol, cured meat (such as salami), sauerkraut, and soy sauce. Check the expiration dates on packages. Tyramine levels get higher as food gets older or if it has not been refrigerated properly.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, Parkinson disease, diabetes, epilepsy (seizures), overactive thyroid, or a history of mania or drug or alcohol addiction.
• This medicine may cause the following problems:
  • Extremely high blood pressure, which could be life-threatening
  • Serotonin syndrome (may be life-threatening when used with certain other medicines)
  • Low blood pressure
  • Liver problems
  • Seizures
• For some children, teenagers, and young adults, this medicine may increase mental or emotional problems. This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or anyone in your family has a history of bipolar disorder or suicide attempts.
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you feel lightheaded.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Anxiety, restlessness, fever, muscle spasms, twitching, diarrhea, seeing or hearing things that are not there
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Feeling more excited or energetic than usual, trouble sleeping
• Frequent or severe headache, fast or pounding heartbeat
• Lightheadedness, dizziness, or fainting
• Seizures
• Stiff neck, sweating, light sensitivity
• Unusual behavior, thoughts of hurting yourself or others

If you notice these less serious side effects, talk with your doctor:

• Dry mouth
• Loss of appetite, constipation

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088