Parnate (Tranylcypromine) Dosage and Side Effects
PARNATE has been prescribed to you by your doctor to relieve your symptoms of depression.
Proper Use of this medication
- It is important that you take PARNATE exactly as your doctor has instructed. The usual starting dose of PARNATE is one 10 mg tablet taken twice a day.
- PARNATE tablets are usually taken in the morning and again mid-afternoon. It is better if you take your tablets at the same times each day.
- You should continue to take your medicine even if you do not feel better, as it may take a number of weeks for your medicine to work.
- Keep taking your tablets, as instructed, until the doctor tells you to stop.
- Talk to your doctor before you stop taking your medication on your own.
Remember: This medicine has been prescribed only for you. Do not give it to anybody else, as they may experience undesirable effects, which may be serious.
If you have taken a large number of tablets all at once, go to the nearest hospital emergency department immediately, even though you may not feel sick. Show the doctor your pack of tablets.
If you forget to take a PARNATE tablet, do not try to make up for the dose that you missed by taking more than one dose at a time. Wait until the next dose and take your normal dose then.
Like all medications, PARNATE can cause some side effects. You may not experience any of them. For most patients these side effects are likely to be minor and temporary. However, some may be serious. Consult your doctor if you experience these or other side effects, as the dose may have to be adjusted.
If you experience an allergic reaction (including skin rash, hives, swelling, trouble breathing) or any severe or unusual side effects, stop taking the drug and go to the nearest hospital emergency department immediately.
The most common side effects of PARNATE are:
- sleep disturbances (insomnia)
- dry mouth
- loss of appetite
PARNATE does not usually affect people's normal activities. However, some people feel drowsiness, dizziness or light headedness while taking it, in which case they should not drive or operate machinery.
Tell your doctor immediately if you notice any of the following:
- severe dizziness or fainting on standing
- fast heartbeat
- blurred vision
- unusual bleeding or bruising
- agitation, confusion or nervousness
- muscle spasms or twitches
- difficulty passing urine
- unusual hair loss or thinning
Stop taking PARNATE and contact your doctor or go to the emergency department of your nearest hospital if the following happens:
- severe or frequent headaches, chest pain, fast or slow heartbeat, neck stiffness or soreness, sweating with initial paleness followed by flushing of the skin, enlarged pupils, nausea and vomiting.
Other rare side effects that have been reported include disorders of the liver and blood.
New or Worsened Emotional or Behavioral Problems:
Particularly in the first few weeks or when doses are adjusted, a small number of patients taking drugs of this type may feel worse instead of better; for example, they may experience unusual feelings of agitation, hostility or anxiety, or have impulsive or disturbing thoughts such as thoughts of self-harm or harm to others. Should this happen to you, or to those in your care if you are a caregiver or guardian, consult your doctor immediately. Close observation by a doctor is necessary in this situation. Do not discontinue your medication on your own. See also Warnings and Precautions:.
Drug Dependence and Discontinuation Symptoms:
It is possible to become dependent on PARNATE. You may experience unwanted effects when you stop taking PARNATE. Withdrawal symptoms such as sleep disturbances, depression, confusion, agitation, hallucinations and other symptoms have been reported after stopping treatment of PARNATE. Tell your doctor as soon as possible if you have these or any other symptoms. Contact your doctor before stopping or reducing your dosage of PARNATE.
Warnings and Precautions
Serious Warnings and Precautions
- New or Worsened Emotional or Behavioral Problems: Particularly in the first few weeks or when doses are adjusted, a small number of patients taking drugs of this type may feel worse instead of better; for example, they may experience unusual feelings of agitation, hostility or anxiety, or have impulsive or disturbing thoughts such as thoughts of self-harm or harm to others. Should this happen to you, or to those in your care if you are a caregiver or guardian, consult your doctor immediately. Close observation by a doctor is necessary in this situation. Do not discontinue your medication on your own.
- Hypertensive Crisis: Certain foods and drinks must be avoided during treatment with PARNATE and for two weeks after stopping treatment. This hypertensive reaction can be life-threatening, depending on the amount of tyramine that has been taken (see Interactions with This Medication:).
BEFORE you use PARNATE, tell your doctor or pharmacist:
- all your medical conditions, including a history of stroke, liver disease, blood disorders, kidney disease, heart problems, diabetes, epilepsy, or overactive thyroid gland
- if you have or have ever had recurrent or frequent headaches
- any medications (prescription or non prescription) which you are taking or have recently taken, especially any other antidepressants
- if you are pregnant, plan to become pregnant, or are breastfeeding
- if you are beyond the age of sixty
- your habits of alcohol and/or street drug consumption
- if you had any type of surgery or are planning to have surgery
Effects on Pregnancy and Newborns:
As stated above, ask your doctor or pharmacist for advice before taking any medicine including PARNATE. If you are already taking/using PARNATE and have just found out that you are pregnant, you should talk to your doctor immediately. You should also talk to your doctor if you are planning to become pregnant.
Children and adolescents (less than 18 years of age):
Treatment with antidepressants is associated with an increased risk of suicidal thinking and behaviour in children and adolescents with depression.
PARNATE may cause an acute attack of glaucoma. Having your eyes examined before you take this drug could help identify if you are at risk of having angle-closure glaucoma. Seek immediate medical attention if you experience:
- eye pain
- changes in vision
- swelling or redness in or around the eye.
Interactions with this medication
Drugs that may interact with PARNATE include:
other antidepressants, such as other MAOIs, selective serotonin reuptake inhibitors (SSRIs), serotonin and noradrenaline reuptake inhibitor (SNRI) and certain tricyclic antidepressants
appetite suppressants such as amphetamines
cold or any hay fever medicines (including nose drops or sprays)
cough suppressant such as dextromethorphan
levodopa and other treatments for Parkinson's disease
other drugs that affect serotonin such as pethidine and tryptophan
medications which lower blood pressure, including guanethidine, reserpine, methyldopa
narcotics and barbiturates
Certain foods and drinks must be avoided during treatment with PARNATE and for two weeks after stopping treatment. PARNATE reacts with a chemical, tyramine, found in various foods, which can cause dangerously high blood pressure (See Serious Warnings and Precautions). This reaction can be life-threatening, depending on the amount of tyramine that has been taken. You should avoid foods in which aging or breakdown is used to increase flavour, including:
matured or aged cheeses
aged, cured or fermented meat, fish or poultry
fermented soybean products, such as soy sauce
fava or broad bean pods
banana peel (but not the pulp)
concentrated yeast extracts
all tap/draught beers
in general, drinking alcoholic beverages should be kept to a minimum or avoided completely while taking PARNATE
Pre-prepared foods such as pizzas, casseroles, meals with sauces, and some restaurant foods may contain these prohibited foods or drink. It is therefore important that you check the ingredients of foods or drink that you have not prepared yourself.
All foods that you eat must be fresh, or properly frozen. Tyramine levels of many foods also increase naturally as they get older, even if they are refrigerated. It is very important that you buy and eat only fresh foods or those which have been properly frozen.
The amounts of tyramine may vary in different brands or even batches of food. A person may absorb different amounts of tyramine from a particular food at different times. Therefore, if you have accidentally taken a prohibited food or drink on one occasion and not had a reaction, you can still have a serious reaction if you take it again.
Your doctor has more information on foods to be careful with or avoid while taking PARNATE. Ask your doctor for advice if you have any questions about this.
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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.