Tranylcypromine

Tranylcypromine is a prescription medication used to treat the symptoms of Major Depressive Disorder.     

•  Tranylcypromine is available under the following different brand names: Parnate 

Adult and Geriatric dosage

Tablet

• 10 mg

Major Depressive Disorder

Adult dosage

• 15 mg orally every 12 hours
• Increase by 5 mg/dose every 1-3 weeks to optimum response; not to exceed 60 mg/day
• May slowly decrease dosage to maintain dose once a response is adequate
• Major Depressive Episode without Melancholia
• Geriatric dosage
• 15 mg orally every 12 hours
• Increase by 5 mg/dose every 1-3 weeks to optimum response; not to exceed 60 mg/day
• May slowly decrease dosage to maintain dose once the response is adequate

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Tranylcypromine include:

• dizziness,
• drowsiness,
• constipation,
• dry mouth,
• blurred vision,
• trouble sleeping,
• headache, and
• feeling shaky or excited

Serious side effects of Tranylcypromine include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• mood or behavior changes,
• anxiety,
• panic attacks,
• trouble sleeping,
• impulsiveness,
• irritableness,
• agitation,
• hostility,
• aggression,
• restlessness,
• hyperactivity (mentally or physically),
• increased depression,
• throughs about suicide,
• dilated pupils,
• vision problems,
• sensitivity to light,
• sudden and severe headache,
• neck pain or stiffness,
• numbness or weakness,
• fast or pounding heartbeats,
• seizures,
• racing thoughts,
• increased energy,
• decreased need for sleep,
• risk-taking behavior,
• being agitated or talkative,
• hallucinations,
• sweating,
• shivering,
• muscle stiffness,
• twitching,
• loss of coordination,
• vomiting,
• diarrhea,
• loss of appetite,
• stomach pain (upper right side),
• dark urine, and
• yellowing of the skin or eyes (jaundice)

Rare side effects of Tranylcypromine include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in your chest; shortness of breath; and sudden dizziness, lightheartedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Tranylcypromine has severe interactions with at least 92 other drugs.
• Tranylcypromine has serious interactions with at least 101 other drugs.
• Tranylcypromine has moderate interactions with at least 91 other drugs.
• Tranylcypromine has minor interactions with the following drugs
  • amobarbital
  • butabarbital
  • butalbital
  • celandine
  • cordyceps
  • Panaxax ginseng
  • pentobarbital
  • phenobarbital
  • pleurisy root
  • primidone
  • ruxolitinib
  • ruxolitinib topical
  • secobarbital
  • sulfadiazine
  • sulfamethoxazole
  • sulfisoxazole

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity 
• Pheochromocytoma, CHF, cerebrovascular defect, CVD, HTN
• Schizophrenia
• History of severe or frequent headaches, liver disease
• Contraindicated with MAOIs or dibenzoazepine-related drugs, sympathomimetics (including amphetamines, which may be found in many herbal preparations), methylphenidates and derivatives, some CNS depressants (e.g., narcotics, alcohol), antihypertensives, diuretics, antihistamines, sedatives, anesthetics, bupropion, buspirone, dextromethorphan, meperidine, SSRIs (e.g., fluoxetine, paroxetine, sertraline), SNRIs (e.g., venlafaxine), levodopa, s-adenosyl-L-methionine (SAM-e), carbamazepine, tapentadol, cyclobenzaprine, methyldopa, tetrabenazine, milnacipran, tryptophan, dopamine, rasagiline, hydroxytryptophan, reserpine
• Sympathomimetic products (e.g., cold, hay fever, or weight-reducing products that contain vasoconstrictors such as pseudoephedrine, phenylephrine, and ephedrine; or dietary supplements that contain sympathomimetics); may cause cerebral hemorrhage
• Discontinue 10 days before surgery
• High tyramine content food (e.g., cheese, beer, Chianti wine, avocados, anchovies, herring, overripe fruit, chocolate, soy sauce, yeasts, yogurt, meat tenderizers, sauerkraut, broad beans)
• Pheochromocytoma and catecholamine-releasing paragangliomas

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Tranylcypromine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Tranylcypromine?”

Cautions

• Clinical worsening & suicide ideation may occur despite medication in adolescents & young adults (18-24 years)
• Caution in patients with diabetes mellitus (monitor glucose closely), glaucoma, hepatic/renal impairment, history of seizures, thyroid dysfunction
• Drug may worsen psychosis in patients with bipolar disorder
• Activation of mania/hypomania may be precipitated by antidepressant treatment in patients with bipolar disorder; screen patients before treatment
• Hypotension (including syncope) may occur; monitor patients and adjust the dosage or concomitant medication as necessary
• Hypotension and hypertension during anesthesia and perioperative care may occur; if possible, discontinue therapy before elective surgery
• Hepatitis and elevated liver enzymes may occur; monitor accordingly

Pregnancy & Lactation

• There are limited published reports of placental infarction and congenital anomalies in association with use during pregnancy; however, these reports may not adequately inform the presence or absence of drug-associated risk with the use during pregnancy; animal embryo-fetal development studies were not conducted with tranylcypromine; however, published animal reproduction studies report the placental transfer of tranylcypromine in rats and a dose-dependent decrease in uterine blood flow in pregnant sheep; advise pregnant women of the potential risk to a fetus
• Lactation
  • Tranylcypromine is present in human milk; there is no available information on the effects of tranylcypromine on milk production; there is no available information the on effects of tranylcypromine on a breastfed child; however, because of the potential for serious adverse reactions in a breastfed infant, advise nursing women to discontinue breastfeeding during treatment