Tranylcypromine | Side Effects, Dosage, Uses & More
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Generic Name:

tranylcypromine, Oral tablet

All Brands

  • Parnate
SECTION 1 of 5

Highlights for tranylcypromine

Oral tablet
1

Tranylcypromine is used to treat depression. It’s often used in people whose depression can’t be controlled with other antidepressant drugs.

2

Tranylcypromine comes in the form of a tablet you take by mouth.

3

The more common side effects of this drug include anxiety, agitation, headache, feeling weak or tired, and trouble sleeping.

4

Tranylcypromine may increase suicidal thoughts or actions in some children, teenagers, or young adults. This typically occurs within the first few months of treatment, or when the dosage is changed.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Suicide risk warning. This drug may increase suicidal thoughts or actions in some children, teens, and young adults. This typically occurs within the first few months of treatment. Your risk is increased if you have a personal or family history of bipolar disorder. It’s also increased if you’ve had suicidal thoughts or behaviors in the past.

Very high blood pressure

This drug can cause very high blood pressure, which can lead to bleeding in the brain or death. Symptoms of very high blood pressure include headache, a fast or slow heartbeat, chest pain, neck stiffness or soreness, and nausea and vomiting. They also include sweating with fever or cold and clammy skin, large pupils (the black centers of the eyes), and being sensitive to light. If you any of these symptoms, call your doctor right away.

Orthostatic hypotension

This drug can cause low blood pressure that happens when you change positions. It typically occurs if you stand quickly after sitting or lying down. Symptoms include dizziness or feeling faint. If this occurs, your doctor may stop your treatment with this drug, or lower your dosage.

Drug features

Tranylcypromine is a prescription drug. It comes in the form of a tablet you take by mouth.

Tranylcypromine is available as the brand-name drug Parnate. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. 

This drug may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Tranylcypromine is used to treat depression. It’s often used in people with depression that can’t be controlled with other antidepressant drugs.

How it works

This drug belongs to a class of drugs called monoamine oxidase inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

More Details

How it works

This drug belongs to a class of drugs called monoamine oxidase inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

In your body, an enzyme called monoamine oxidase breaks down certain chemicals that affect your mood. These chemicals include epinephrine, norepinephrine, and dopamine. Tranylcypromine works by blocking the enzyme. This increases the levels of these chemicals and helps relieve depression symptoms.

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tranylcypromine Side Effects

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More Common Side Effects

The more common side effects of tranylcypromine can include:

  • dizziness

  • headache

  • drowsiness

  • trouble sleeping

  • weakness

  • tremors (shaking)

  • twitching

  • jerking movements

  • constipation

  • dry mouth

  • stomach upset

  • weight gain

  • dizziness after standing up

  • swelling of your feet or legs

  • delayed ejaculation (in men)

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Mental health or behavior problems. Symptoms can include:

    • thoughts about suicide or dying
    • attempts to commit suicide
    • new or worse depression
    • new or worse anxiety
    • feeling very agitated or restless
    • panic attacks
    • trouble sleeping
    • new or worse irritability
    • acting aggressive, angry, or violent
    • acting on dangerous impulses
    • mania (an extreme increase in activity and talking)
    • other unusual changes in behavior or mood
  • Hypertensive crisis (severely high blood pressure). Symptoms can include:

    • severe headache
    • fast or slow heartbeat
    • chest pain
    • neck stiffness or soreness
    • nausea or vomiting
    • sweating, with fever or cold, clammy skin
    • large pupils (the black centers of the eyes)
    • being sensitive to light
  • Mania. Symptoms can include:

    • greatly increased energy levels
    • severe trouble sleeping
    • racing thoughts
    • reckless behavior
    • unusually big or bold ideas
    • feeling very happy or irritable
    • talking more or faster than usual
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug may cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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tranylcypromine May Interact with Other Medications

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Tranylcypromine can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Food interactions

Avoid eating foods that contain the substances tyramine or dopamine. These substances raise your risk of severe, uncontrolled high blood pressure. Foods that contain these substances include cured meat or fish, cheese, or yogurt. Also avoid consuming large amounts of caffeine or chocolate. Your doctor or dietitian can tell you more.

Alcohol interaction

Don’t drink beer or wine, including alcohol-free or reduced-alcohol products, while taking this drug. You should also avoid them for two weeks after stopping tranylcypromine. These drinks contain tyramine. This substance raises your risk of severe, uncontrolled high blood pressure.

Avoid other drinks that contain alcohol. These drinks can increase the drowsiness caused by tranylcypromine.

Medications that might interact with this drug

Drugs you should not use with tranylcypromine

Do not take these drugs with tranylcypromine. Doing so can cause dangerous effects in the body. Examples of these drugs include:

  • Stimulant-type drugs, such as amphetamines, cocaine, methylphenidate, dopamine, epinephrine, norepinephrine, or methyldopa.
    • Taking these drugs with tranylcypromine raises your risk of high blood pressure.
  • Central nervous system depressants, such as dextromethorphan or narcotic pain medications, including oxycodone, hydrocodone, morphine, or tramadol.
    • Taking these drugs with tranylcypromine raises your risk of drowsiness. It may also cause bizarre or unusual behavior.
  • Monoamine oxidase inhibitors (MAOIs), such as procarbazine or phenelzine.
    • Tranylcypromine is an MAOI. Using MAOIs together can cause a condition called a hypertensive crisis (severely high blood pressure). It can also cause seizures, fever, sweating, excitation, confusion, tremor, coma, cardiac arrest, or death. Wait at least 14 days after stopping another MAOI before starting tranylcypromine.
  • Meperidine.
    • A single dose of meperidine taken with tranylcypromine can cause severe reactions. These include excitation, seizure, delirium, fever, coma, cardiac arrest, or death.
  • Buspirone.
    • Taking buspirone with tranylcypromine can cause high blood pressure. Wait at least 14 days after stopping tranylcypromine before starting buspirone.
  • Serotonin reuptake inhibitors (SSRIs), such as fluoxetine, paroxetine, sertraline, citalopram, or venlafaxine.
    • Taking tranylcypromine with drugs that increase your levels of the hormone serotonin can cause serious reactions. These include fever, rigid muscles, strange body movements, or death. Wait at least 14 days after stopping tranylcypromine before starting an SSRI (except fluoxetine), and vice versa. Wait at least 5 weeks after stopping tranylcypromine before starting fluoxetine.
  • Bupropion.
    • Taking this drug with tranylcypromine raises your risk of high blood pressure. Wait at least 14 days after stopping tranylcypromine before starting bupropion.
  • Certain over-the-counter medications, such as drugs for cough and cold, hay fever, sinus problems, asthma, weight loss, or stuffy nose.
    • Taking these medications with tranylcypromine can raise your blood pressure. This can cause headache and other serious symptoms.

Interactions that increase your risk of side effects

Side effects from tranylcypromine: Taking tranylcypromine with certain medications raises your risk of side effects from tranylcypromine. This is because the amount of tranylcypromine in your body may be increased. Examples of these drugs include:

  • Other antidepressants, such as amitriptyline, desipramine, or doxepin.
    • These drugs can increase the harmful side effects of tranylcypromine when taken with it or within seven days of stopping it. Increased side effects can include severely high blood pressure or seizures.
  • Anti-seizure drugs, such as carbamazepine.
    • These drugs can increase the harmful side effects of tranylcypromine when taken with it, or within seven days of stopping it. Increased side effects can include severely high blood pressure or seizures.
  • Muscle relaxers, such as cyclobenzaprine.
    • These drugs can increase the harmful side effects of tranylcypromine when taken with it, or within 7 days of stopping it. Increased side effects can include severely high blood pressure or seizures.
  • Blood pressure medications.
    • Increased side effects can include low blood pressure.

Side effects from other drugs: Taking tranylcypromine with certain medications raises your risk of side effects from these drugs. Examples of these drugs include:

  • Anti-psychotics, such as fluphenazine, perphenazine, or chlorpromazine.
    • Taking tranylcypromine with drugs that cause low blood pressure raises your risk of very low blood pressure. This can be dangerous.
  • Nausea drugs, such as promethazine or prochlorperazine.
    • Taking tranylcypromine with drugs that cause low blood pressure raises your risk of very low blood pressure. This can be dangerous.
  • Anesthesia drugs.
    • Taking tranylcypromine with certain anesthesia drugs can cause severely low blood pressure. Don’t have elective surgery that uses general anesthesia while taking this drug. This drug should be stopped at least 10 days before surgery. (Elective surgery is any surgery that’s not an emergency.)

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with a history of pheochromocytoma

Don’t use this drug. This condition raises your risk of high blood pressure. This drug can also cause very high blood pressure.

People with a history of heart problems or stroke

Don’t use this drug. This drug can cause very high blood pressure. This can make your heart condition worse.

People with a history of kidney problems

This drug is removed from your body through your kidneys. If your kidneys aren’t working well, this drug can build up in your body. This raises your risk of side effects. If you have mild to moderate kidney problems, talk with your doctor about whether this drug is safe for you. If you have severe kidney problems, do not take this drug.

People with a history of liver problems:

This drug is broken down in your body by your liver. If you have a history of liver disease, this drug can build up in your body. This raises your risk of dangerous side effects. If you have liver problems, do not take this drug.

People with a history of seizures

This drug raises your risk of having more seizures. Talk with your doctor about whether this drug is safe for you

People with high thyroid levels

If you have hyperthyroidism (an overactive thyroid), using this drug can increase your blood pressure to an unsafe level. Talk with your doctor about whether this drug is safe for you.

People with a history of mania

A common side effect of this drug is agitation and excitement. This can lead to mania in people with a history of the condition. These effects are more likely to occur with higher doses of this drug, or if it’s used for a long period of time.

People with a history of diabetes

This drug may make your body more sensitive to insulin. Your doctor may lower the dosage of your diabetes medication.

People with a history of headaches

Do not take this drug. It can make your headaches worse.

People with heart disease

This drug can hide certain symptoms in people with CAD (coronary artery disease). These include pain and tightening in the chest. If you have heart disease, do not take this drug.

Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding

This drug passes into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

For children

It has not been confirmed that this drug is safe and effective for use in people younger than 18 years.

Allergies

This drug can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take tranylcypromine (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Depression

Generic: tranylcypromine

Form: Oral tablet
Strengths: 10 mg

Brand: Parnate

Form: Oral tablet
Strengths: 10 mg
Adult dosage (ages 18–64 years)
  • Typical starting dosage: You may start with 30 mg per day in divided doses.
  • Dosage increases: If your depression symptoms don’t improve for up to two weeks, your doctor may increase your dosage by 10 mg at a time. They may increase your dosage every one to three weeks.
  • Maximum dosage: 60 mg per day.
Child dosage (ages 0–17 years)

It has not been confirmed that tranylcypromine is safe and effective for use in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Warnings

Using high doses. Using very high doses of tranylcypromine can cause drug dependence (addiction). This can cause the following withdrawal symptoms:

  • restlessness
  • anxiety
  • depression
  • confusion
  • hallucinations (seeing or hearing things that aren’t real)
  • headache
  • weakness
  • diarrhea

If you take high doses of this drug, your doctor should monitor you carefully. This is especially true if you have a history of substance abuse.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Stopping this drug may cause your symptoms of depression to return. Your symptoms may even get worse. Stopping this drug suddenly may cause withdrawal symptoms. These can include restlessness, anxiety or depression, weakness, or headache.

If you don’t take this drug at all, your symptoms may continue or get worse.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous amounts of the drug in your body. Symptoms of an overdose of this drug can include:

  • drowsiness
  • dizziness
  • feeling faint
  • irritability
  • being hyperactive
  • agitation
  • severe headache
  • hallucinations (seeing or hearing things that aren’t real)
  • rigid muscles, including in your jaw, head, neck, or back
  • convulsions (muscle tightening that you can’t control)
  • coma
  • fast or irregular heartbeat
  • high or low blood pressure
  • breathing problems
  • fever
  • sweating
  • cool, clammy skin

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away. 

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

Your depression symptoms should become less severe, or occur less often.

This drug is used for long-term treatment.

Important considerations for taking this drug
take with or without food You can take this drug with or without food
timing Take this drug at the time(s) recommended by your doctor
can crush or cut You can cut or crush the tablet
storage Store this drug carefully See Details
refillable A prescription for this medication is refillable See Details
travel Travel See Details
clinical monitoring Clinical monitoring See Details
not usually stocked Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead.
insurance Insurance See Details

Store this drug carefully

  • Store this drug at room temperature between 59°F and 86°F (15°C and 30°C).
  • Keep this drug away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Mental health and depression. You and your doctor should monitor your symptoms of depression. Watch for suicidal thoughts, especially during your first few months of treatment and after dosage changes. Call your doctor right away if you notice new or sudden changes in your mood, behavior, thoughts, or feelings.
  • Blood pressure. Your doctor will monitor your blood pressure. They will make sure it’s not too high or low.
  • Kidney function. Your doctor will monitor how well your kidneys are working. If you have kidney problems, you are at higher risk of side effects.
  • Liver function. Your doctor will monitor how well your liver is working. If you develop liver problems, you will need to stop taking this drug.
  • Blood glucose. If you have diabetes, you and your doctor should monitor your blood sugar level more closely. This is especially important when starting or stopping this drug, and during dosage increases.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

What does the pill look like?

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How Much Does tranylcypromine Cost?

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These prices represent the lowest priced national pharmacies for tranylcypromine on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on December 7, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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