• Basic Info
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What is tranylcypromine?
Tranylcypromine is a monoamine oxidase inhibitor (MAOI) that works by increasing the levels of certain chemicals in the brain. Tranylcypromine is used to treat major depressive episode in adults. This medication is usually given after other anti-depressants have been tried without successful treatment of symptoms. Tranylcypromine will not treat bipolar disorder (manic depression). Tranylcypromine may also be used for purposes other than those listed in this medication guide.

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What are the possible side effects of tranylcypromine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Stop using tranylcypromine and call your doctor at once if you have any of these serious side effects:

• frequent headaches, vision problems, sensitivity to light;

• fast or pounding heart beats, tight feeling in your chest or throat;

• swelling of your ankles or feet;

• pale skin, easy bruising or bleeding, unusual weakness;

• nausea, vomiting, dizziness, sweating, stiffness in your neck;

• confusion, lack of coordination, feeling light-headed, fainting; or

• tremors, muscle twitches you cannot control.

Continue taking this medication and talk to your doctor if you have any of these less serious side effects:

• feeling restless, weak, or drowsy;

• nausea, diarrhea or constipation, loss of appetite, stomach pain;

• chills, numbness or tingly feeling;

• dry mouth, decreased urination;

• blurred vision, ringing in your ears; or

• impotence, difficulty having an orgasm.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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How should I take tranylcypromine?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the instructions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Take each dose with a full glass of water. You may need to stop using the medicine for a short time if you need to have any type of surgery, or if you will have an x-ray, CT scan, or MRI of your spinal cord. Tell any doctor who treats you that you are taking tranylcypromine.

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What is the most important information I should know about tranylcypromine?
There are many other medicines that can cause serious medical problems if you take them together with tranylcypromine. Do not take tranylcypromine before telling your doctor about all other prescription and over-the-counter medications you use, including vitamins, minerals, and herbal products. Keep a list with you of all the medicines you use and show this list to any doctor, dentist, or other healthcare provider who treats you. You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

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What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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What other drugs will affect tranylcypromine?
There are many other medicines that can cause serious medical problems if you take them together with tranylcypromine. Do not take tranylcypromine before telling your doctor about all other prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor, dentist, or other healthcare provider who treats you.

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Tranylcypromine has not been formally assigned to a pregnancy category by the FDA. Tranylcypromine crosses the placenta in rats. There are no controlled data in human pregnancy. Tranylcypromine is only recommended for use during pregnancy when benefit outweighs risk.

In a review of 21 mother-child pairs exposed to monoamine oxidase inhibitors in the first trimester by the Collaborative Perinatal Project, 13 of the pairs were exposed to tranylcypromine. Of the 21 infants, three had malformations. However, details with respect to tranylcypromine exposure were unavailable. A 41-year-old woman treated with tranylcypromine (100 mg/day), pimozide (1 mg/day) and diazepam (5 to 10 mg/day) for severe depression delivered a stillborn fetus at 31-weeks gestation. Upon examination the stillborn infant revealed hypertelorism, a large atrioventricular septal defect, a single coronary ostium, and a right pulmonary isomerism. In addition, the placenta had multiple infarcts that may have contributed to the fetal death. In her second pregnancy, an ultrasound at 19-weeks gestation showed a fetus with a 'lemon-shaped' head. In another case, a female infant was delivered at 38-weeks gestation because of poor growth. The infant also had multiple defects including hypertelorism, low-set overfolded ears, cleft palate, micrognathia, distal phalangeal hypoplasia, agenesis of the corpus callosum, and atrioventricular septal defect. These outcomes have been attributed to tranylcypromine and possibly a result of reduced uterine and placental blood flow.

Tranylcypromine is excreted into human milk. There are no data on the use of tranylcypromine during lactation, and the potential effects in a nursing infant are unknown. Tranylcypromine is only recommended for use during lactation when benefit outweighs risk.

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What does my medication look like?
Tranylcypromine is available with a prescription under the brand name Parnate. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you. Parnate 10 mg--round, red tablets

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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a tranylcypromine overdose may include feeling restless or anxious, sleep problems (insomnia), agitation, confusion, weakness, severe headache, neck pain or stiffness, fast or pounding heart beats, chest pain, cold sweats, feeling light-headed, or fainting.

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What should I discuss with my healthcare provider before taking tranylcypromine?
Do not use this medication if you have used another MAOI such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam) within the past 14 days. Serious, life-threatening side effects can occur if you take tranylcypromine before another MAOI has cleared from your body. If you are switching to tranylcypromine from another MAOI, your doctor may start you at a low dose. There are many other medicines that can cause serious medical problems if you take them together with tranylcypromine. The following drugs should not be used while you are taking tranylcypromine:

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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