Manerix (Moclobemide) Dosage and Side Effects
MANERIX is used to treat depression. Depression is believed to be caused by imbalances in certain brain chemicals. This medication works by bringing these chemicals back into balance.
Proper Use of this medication
The usual starting dose of MANERIX for adults is 150 mg twice daily. If necessary, your doctor may gradually increase your dose after the first week to a maximum of 300 mg twice daily. The recommended dose of MANERIX for adults ranges from 150 mg to 300 mg, taken twice daily after meals.
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- dryness of mouth
- trouble sleeping
Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- blurred vision or other changes in vision
- fast, racing, or irregular heartbeat
- feeling confused, disoriented, or lost
- slow heartbeat
- slurred speech
- stiff neck, severe throbbing headache
- symptoms of low sodium levels in the blood (e.g., achy, stiff or uncoordinated muscles, confusion, tiredness, weakness)
- thoughts of self-harm or hurting others
Stop taking the medication and seek immediate medical attention if any of the following occur:
- signs of a hypertensive reaction (e.g., severe headache with confusion and blurred vision, nausea, vomiting, severe anxiety, difficulty breathing, severe chest pain, seizures)
- signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
- signs of serotonin syndrome (too much serotonin in the body; e.g., fast or racing heartbeat, loss of coordination, agitation, decreased reflexes, rapid changes in blood pressure, fever, heavy sweating, confusion)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Warnings and Precautions
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
Do not take this medication if you:
- are allergic to MANERIX or any ingredients of the medication
- are in an acute state of confusion
- are are taking any of the following medications:
- other MAO inhibitors (e.g., tranylcypromine)
- SNRI antidepressants (e.g., desvenlafaxine)
- SSRI antidepressants (e.g., fluoxetine, sertraline)
- tricyclic antidepressants (e.g., amitriptyline)
- “triptan” migraine medications (e.g., sumatriptan)
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Diet restrictions: Treatment with MANERIX does not require special diet restrictions as with other MAO inhibitors such as phenelzine. As a safety measure, immediately report the sudden occurrence of any of the following:
- extremely fast or slow heart rate
- neck stiffness
- other unusual symptoms not previously experienced
Drowsiness/reduced alertness: This medication may cause drowsiness or dizziness. Do not drive, operate machinery, or perform other potentially hazardous tasks until you have determined how this medication affects you.
Kidney disease: If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. For people with severe liver dysfunction, the daily dose of MANERIX should be reduced to one-third or one-half of the standard dose.
Other medications: Treatment with tricyclic antidepressants may be started after MANERIX has been stopped for at least 2 days. Do not start treatment with MANERIX until antidepressants have been stopped for 2 weeks in most cases (wait 5 weeks after taking fluoxetine).
Suicidal or agitated behaviour: People taking this medication may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after starting this medication. If you experience these side effects or notice them in a family member who is taking this medication, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking this medication.
Thyroid disease: With certain types of thyroid disease, this medication can cause a severe increase in blood pressure. If you have thyroid disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Pregnancy: The safety of using MANERIX during pregnancy has not been established. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking MANERIX, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.
Interactions with this medication
There may be an interaction between MANERIX and any of the following:
- acetylcholinesterase inhibitors (e.g., donepezil, galantamine, rivastigmine)
- alpha/beta agonists (e.g., epinephrine, norepinephrine)
- alpha agonists (e.g., clonidine, methyldopa)
- amphetamines (e.g., dextroamphetamine)
- anesthetics (e.g., halothane)
- angiotensin receptor blockers (ARBs; e.g., candasartan, irbesartan, losartan)
- anti-emetic medications (e.g., granisetron, ondansetron)
- antihistamines (e.g,. cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
- antipsychotic medications (e.g., haloperidol, quetiapine, risperidone)
- appetite suppressants (e.g., sibutramine, mazindol)
- “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
- beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
- beta-2 agonists (e.g., salbutamol, formoterol, terbutaline)
- calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
- decongestants (e.g., phenylephrine, oxymetazoline, pseudoephedrine, tetrahydrazoline, xylometazoline)
- diabetes medications (e.g., chlorpropamide, glipizide, glyburide, insulin, metformin, nateglinide, rosiglitazone)
- ergot alkaloids (e.g., ergotamine, dihydroergotamine)
- glaucoma medications (e.g., apraclonidine, brimonidine)
- other monoamine oxidase inhibitors (MAOIs; e.g., MANERIX, phenelzine, rasagiline, selegiline, tranylcypromine)
- narcotic medications (e.g., fentanyl, morphine, codeine, oxycodone)
- potassium chloride
- St. John's wort
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
- serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
- sympathomimetic medications (e.g., epinephrine, norepinephrine)
- tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine)
- "triptan" migraine medications (e.g., rizatriptan, sumatriptan)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.