Parnate

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

Parnate is prescribed to treat major depressive episodes in adults when other treatments have not worked.

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

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Your blood pressure will need to be checked often.

You may need to stop using Parnate for a short time before any type of surgery or medical procedure. Tell any doctor who treats you that you take this medicine.

It may take a few weeks before you receive the full benefit of taking Parnate. Your doctor will determine how long to treat you with Parnate.

Do not stop using Parnate suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat.

Some young people may have thoughts about suicide when they first start taking an antidepressant. Be aware of any changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

There are many other medicines, foods, and drinks that can cause serious health issues if taken with Parnate. Inform your doctor about all your current medicines and any that you start or stop. Avoid drinking alcohol, and find out which foods you should stay away from.

Eating foods high in tyramine while taking Parnate can lead to dangerously high blood pressure. Symptoms include a sudden and severe headache, nausea, vomiting, fever, cold sweat, dilated pupils, sensitivity to light, fast or pounding heartbeats, neck stiffness, weakness, or problems with vision or speech.

You should not use Parnate if you are allergic to it, or if you have:

• pheochromocytoma (tumor of the adrenal gland).

A dangerous interaction could happen between Parnate and certain other medications you have taken in the past 14 days. You should not take this medicine if you also use:

• other antidepressants;
• buspirone, carbamazepine, reserpine, tapentadol, tetrabenazine, tryptophan, SAM-e;
• diet pills, stimulants, ADHD medications, cough and cold or allergy medicines;
• another MAO inhibitor--isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, and others; or
• drugs that affect serotonin levels in your body--stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.

Tell your doctor if you have ever had:

• heart disease, high or low blood pressure, circulation problems, or a stroke;
• bipolar disorder (manic depression);
• liver disease;
• a thyroid disorder;
• headaches;
• diabetes (Parnate may cause low blood sugar); or
• a seizure.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Parnate may harm an unborn baby. Tell your doctor if you are pregnant or if you become pregnant.

You should not breast-feed while using Parnate.

Parnate is not approved for use by anyone younger than 18 years old.

Get emergency medical help if you have 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: changes in mood or behavior, 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.

Parnate may cause serious side effects. Call your doctor right away if you experience:

• dilated pupils, vision problems, sensitivity to light;
• sudden and severe headache, neck pain or stiffness;
• numbness or weakness, problems with vision or speech;
• fast or pounding heartbeats;
• fever, cold sweat, nausea, vomiting;
• a light-headed feeling, like you might faint;
• a seizure;
• manic episodes--racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, being agitated or talkative;
• high levels of serotonin in the body--agitation, hallucinations, sweating, shivering, muscle stiffness, twitching, loss of coordination, vomiting, diarrhea; or
• liver problems--loss of appetite, stomach pain (upper right side), dark urine, jaundice (yellowing of the skin or eyes).

Serious side effects may be more likely in older adults.

Common side effects of Parnate may include:

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

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.

Take the medicine as soon as possible, but skip the missed dose if it is nearly time for your next dose. Do not take two doses at the same time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include feeling restless or anxious, sleep problems, agitation, confusion, weakness, severe headache, neck pain or stiffness, pounding heartbeats, or loss of consciousness.

Do not drink alcohol. Dangerous side effects could occur.

You must not eat foods that are high in tyramine, including:

• air dried, aged or fermented meats, including sausage or salami;
• beer on tap (not in a bottle or can);
• pickled herring;
• aged cheeses, including blue, boursault, brie, camembert, cheddar, gruyere, mozzarella, parmesan, Romano, Roquefort, and Swiss;
• moldy or improperly stored meat, fish, poultry, or liver;
• soy sauce, miso soup, bean curd, fava beans; or
• yeast extracts, Marmite.

Eating tyramine while you are taking Parnate can raise your blood pressure to dangerous levels, causing life-threatening side effects. Also avoid tyramine for 2 weeks after you stop taking this medicine.

Avoid driving or hazardous activity until you know how Parnate will affect you. Your reactions could be impaired.

When you begin or stop taking Parnate, your doctor may need to change the doses of any other medicines you regularly take.

There are many other drugs that can cause serious medical problems if taken with Parnate. 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 your current medicines and any medicine you start or stop using.

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