Phenelzine

Phenelzine is a monoamine oxidase inhibitor (MAOI) that helps treat symptoms of atypical depression in adults when other medicines have not worked.

Phenelzine is not for treating severe depression or bipolar disorder (manic depression).

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

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

Your blood pressure will need to be checked frequently.

You may need to stop using phenelzine for a short time before any surgery or medical procedure. Inform any doctor treating you that you take phenelzine.

It may take a few weeks before you experience the full benefits of taking phenelzine. Your doctor will decide how long you should be treated with phenelzine.

Do not stop using phenelzine suddenly, as this could lead to unpleasant withdrawal symptoms. Ask your doctor how to safely stop taking this medicine.

Store at room temperature, away from moisture and heat.

Some young people may have thoughts of suicide when they start taking an antidepressant. Pay attention to any changes in your mood or symptoms. Inform your doctor about any new or worsening symptoms.

Many other medications, foods, and drinks can lead to dangerously high blood pressure if taken with phenelzine. Make sure to tell your doctor about all the medicines you are currently using and any you begin or stop. Avoid drinking alcohol, and find out which foods you should stay away from.

Signs of dangerously high blood pressure include: a sudden and severe headache, nausea, vomiting, fever, cold sweat, dilated pupils, light sensitivity, fast or pounding heartbeats, neck stiffness, weakness, or issues with vision or speech.

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

• pheochromocytoma (tumor of the adrenal gland).
• congestive heart failure;
• severe kidney disease; or
• a history of liver problems or abnormal liver function tests.

A dangerous drug interaction can happen between phenelzine and certain other medicines you take within 14 days before or after taking phenelzine. Your doctor may change your treatment plan if you need to use any of these medicines, including:

• epinephrine or norepinephrine;
• bupropion, buspirone, carbamazepine, guanethidine, levodopa, meperidine, methyldopa, tryptophan;
• ADHD medication;
• diet pills, cough and cold or allergy medicines;
• opioid medicine;
• other antidepressants;
• another MAO inhibitor--furazolidone, isocarboxazid, linezolid, methylene blue injection, procarbazine, rasagiline, selegiline, tranylcypromine, 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.

This is not a complete list and there may be other medicines you should not take while you are taking phenelzine.

Tell your doctor if you have ever had:

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

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 aware of changes in your mood or symptoms.

Tell your doctor if you are pregnant or breastfeeding.

Phenelzine 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: 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.

Phenelzine may cause serious side effects. Call your doctor at once if you have:

• sudden and severe headache, neck pain or stiffness;
• pounding heartbeats or fluttering in your chest;
• fast or slow heartbeats;
• chest pain;
• a light-headed feeling, like you might pass out;
• sweating (sometimes with fever and sometimes with cold, clammy skin);
• nausea, vomiting; or
• dilated pupils (your eyes may be more sensitive to light).

Common side effects of phenelzine may include:

• dizziness, feeling light-headed;
• drowsiness, sleep problems;
• headache;
• feeling weak or tired;
• tremors, muscle twitching;
• dry mouth, stomach discomfort, constipation;
• swelling, weight gain; or
• sexual problems.

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:

Early phase treatment:-Initial dose: 15 mg orally 3 times a day-Dose titration: Increase to at least 60 mg per day fairly rapidly, as tolerated-Maximum dose: 90 mg/dayMaintenance:-Maintenance dose may be as low as 15 mg orally once a day or 15 mg orally every other day-Duration of therapy: As long as requiredComments:-This drug should rarely be the first antidepressant used; it is more suitable for patients unresponsive to more commonly used medications.-This drug is effective in depressed patients characterized as atypical, nonendogenous, or neurotic, who often have mixed anxiety and depression and phobic or hypochondriacal features.-Evidence of usefulness in severely depressed patients with endogenous features is less conclusive.-Clinical response may not be seen until at least 4 weeks at 60 mg per day dosing-After maximal benefit is achieved, reduce dose slowly over several weeks.Use: Treatment of clinically characterized atypical, nonendogenous, or neurotic depression, especially in patients who have failed first-line treatments

Take the medicine as soon as you remember, but skip the missed dose if it's 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 drowsy or dizzy, severe headache, neck pain or stiffness, hallucinations, shallow breathing, fast and uneven heart rate, cold sweats, feeling like you might pass out, or seizure (convulsions).

Do not drink alcohol. Dangerous side effects could occur.

You must not eat certain foods, including:

• air dried, aged, smoked, or fermented meats, including sausage, pepperoni, Lebanon bologna, or salami;
• beer, wine, reduced-alcohol or alcohol-free beer or wine;
• 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;
• sauerkraut;
• yogurt;
• yeast extracts, Marmite; or
• excessive amounts of chocolate or caffeine.

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

Phenelzine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

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

There are many other drugs that can lead to serious health issues if you take them with phenelzine. This includes both prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are mentioned in this medication guide. Inform your doctor about all your current medicines and any medicine you start or stop taking.

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