Isocarboxazid

Isocarboxazid is a monoamine oxidase inhibitor (MAOI) that helps increase the levels of certain chemicals in the brain.

Isocarboxazid is used to treat symptoms of depression, which may include anxiety, panic, or phobias. Isocarboxazid is typically prescribed after other antidepressants have been tried without successfully treating the symptoms.

Isocarboxazid may also be used for reasons not mentioned in this medication guide.

Follow all directions on your prescription label. Your doctor may sometimes change your dose to ensure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Your blood pressure will need to be checked often. You may also need regular blood tests to monitor your liver function.

It may take up to 6 weeks before your symptoms improve. Keep using the medication as directed and inform your doctor if your symptoms do not improve.

If you need surgery, inform the surgeon in advance that you are using isocarboxazid. You may need to stop using the medicine for at least 10 days before surgery.

Store at room temperature away from moisture and heat.

There are many other medicines that can lead to serious health issues or death if taken with isocarboxazid. Before starting isocarboxazid, inform your doctor about all medicines you have taken in the past 5 weeks.

Do not take isocarboxazid if you have used another MAO inhibitor in the past 14 days. This could lead to a dangerous drug interaction. MAO inhibitors include linezolid, methylene blue injection, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine, and others.

Some young people may have thoughts of suicide when they first start an antidepressant. Your doctor will need to monitor your progress at regular visits while you are on isocarboxazid. Your family or caregivers should also watch for any changes in your mood or symptoms.

Report any new or worsening symptoms to your doctor, such as: changes in mood or behavior, anxiety, panic attacks, difficulty sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts of suicide or self-harm.

While taking isocarboxazid, you must not drink alcohol or eat foods that are high in tyramine, which are listed in the "What should I avoid while taking isocarboxazid?" section of this leaflet. Eating tyramine while taking isocarboxazid can raise your blood pressure to dangerous levels.

You should not take isocarboxazid if you are allergic to it, or if you have:

• pheochromocytoma (tumor of the adrenal gland);
• liver disease;
• kidney disease;
• a history of stroke or blood clots;
• heart disease, high blood pressure; or
• a history of severe or frequent headaches.

Many other medicines can cause serious health problems or death if taken together with isocarboxazid.

Before taking isocarboxazid, tell your doctor about all medicines you have used in the past 5 weeks. The following drugs should not be used while you are taking isocarboxazid:

• buspirone (Buspar);
• carbamazepine;
• levodopa;
• methyldopa;
• tryptophan;
• certain antidepressants—amitriptyline, bupropion, citalopram, clomipramine, desipramine, doxepin, escitalopram, fluoxetine, fluvoxamine, imipramine, maprotiline, nortriptyline, paroxetine, protriptyline, sertraline, trimipramine (known by brand names such as Celexa, Lexapro, Luvox, Norpramin, Prozac, Paxil, Wellbutrin, and Zoloft);
• narcotic pain medicine—morphine, tramadol, Demerol, OxyContin, Percocet, Vicodin, and others;
• ADHD medicine—Adderall, Concerta, Ritalin, Vyvanse, and others;
• diet pills; or
• over-the-counter cough or cold medicine.

Do not use isocarboxazid if you have used another MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include linezolid, methylene blue injection, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine, and others.

To make sure isocarboxazid is safe for you, tell your doctor if you have:

• a history of heart disease or high blood pressure;
• diabetes;
• a thyroid disorder;
• schizophrenia;
• epilepsy or another seizure disorder; or
• if you have taken any other antidepressant within the past 5 weeks.

Some young people have thoughts about suicide when they first start taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using isocarboxazid. Your family or other caregivers should also be alert to changes in your mood or symptoms.

FDA pregnancy category C. It is not known if isocarboxazid will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using isocarboxazid.

It is not known if isocarboxazid passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breastfeeding a baby.

Do not give isocarboxazid to anyone younger than 16 years old without the advice of a doctor.

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.

Report any new or worsening symptoms to your doctor, 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 taking isocarboxazid and call your doctor at once if you have:

• sudden and severe headache, rapid heartbeat, stiffness in your neck, nausea, vomiting, cold sweat, vision problems, sensitivity to light;
• chest pain, fast or slow heart rate;
• swelling, rapid weight gain;
• jaundice (yellowing of the skin or eyes); or
• a light-headed feeling, like you might pass out.

Common side effects of isocarboxazid may include:

• headache, dizziness, drowsiness;
• tremors;
• sleep problems (insomnia);
• constipation, nausea; or
• dry mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Usual Adult Dose for Depression:

Initial dose: 10 mg orally 2 times a day-Increase in 10 mg increments every 2 to 4 days, until 40 mg/day is reached (by the end of the first week of treatment); doses should be divided into 2 to 4 doses per day.-After the first week, the dose may be increased in increments of up to 20 mg per week, if needed and tolerated.Maximum dose: 60 mg/dayComments:-Doses should be adjusted based on careful observation of the patient.-After the maximum clinical response is achieved, prescribers should consider reducing the dose slowly over several weeks without jeopardizing therapeutic response.-Benefits may not be seen for 3 to 6 weeks; if a response does not occur within this time, continued use is unlikely to help.-Efficacy has not been established in studies lasting longer than 6 weeks; patients requiring treatment longer than 6 weeks should be evaluated for usefulness.-Use with caution if doses above 40 mg/day are used.Use: Second-line treatment of depression, especially major depressive disorder in patients with or without signs/symptoms of anxiety (e.g., anxious mood, panic, phobic symptoms) who have not responded satisfactorily to other antidepressants

Take the missed dose as soon as you remember. Skip the missed dose if it is close to the time for your next scheduled dose. Do not take extra medicine to compensate for the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include shallow breathing, fast heart rate, sweating, fever, slow reflexes, feeling light-headed, fainting, or seizure (convulsions).

Avoid coffee, tea, cola, energy drinks, or other products that contain caffeine.

While you are taking isocarboxazid you must not drink alcohol or eat foods that are high in tyramine, including:

• cheese (especially strong or aged cheeses);
• sour cream and yogurt;
• beer (including non-alcoholic beer), sherry, Chianti wine, liqueurs;
• dry sausage (such as hard salami, pepperoni), anchovies, caviar, liver, pickled herring;
• canned figs, raisins, bananas;
• avocados;
• chocolate;
• soy sauce;
• sauerkraut;
• fava beans;
• yeast extracts;
• meat extracts; or
• meat prepared with tenderizer.

You should become very familiar with the list of foods and medicines you must avoid while you are taking isocarboxazid. Eating tyramine while you are taking isocarboxazid can raise your blood pressure to dangerous levels which could cause life-threatening side effects.

Isocarboxazid may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Taking isocarboxazid with other drugs that make you sleepy can make you feel even more tired. Ask your doctor before taking isocarboxazid with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with isocarboxazid, and some drugs should not be taken together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are included in this medication guide. Inform your doctor about all medicines you are using, as well as any that you start or stop while being treated with isocarboxazid. Provide a list of all your medicines to any healthcare provider who treats you.

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