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Drug Name:


Generic Name and Formulations:
Tranylcypromine (as sulfate) 10mg; tabs.

Concordia Pharmaceuticals Inc.

Therapeutic Use:

Indications for PARNATE:

Major depressive disorder in those who have not responded adequately to other antidepressants.


30mg daily in divided doses. If no improvement after 2 wks, may increase in 10mg/day increments every 1–3 wks; usual max 60mg/day.


Not recommended: see full labeling.


See Interactions. Pheochromocytoma. Catecholamine-releasing paragangliomas. To avoid potentially severe or fatal interactions, allow sufficient drug-free interval (see full labeling) between tranylcypromine and sympathomimetics (eg, amphetamines, pseudoephedrine), tricyclic antidepressants (eg, amitriptyline, clomipramine), SSRIs (eg, fluoxetine) or SNRIs (eg, venlafaxine), maprotiline, mirtazapine, CNS depressants (eg, alcohol, barbiturates, narcotics), antihistamines, antihypertensives (eg, guanethidine), anesthetics, bupropion, buspirone, carbamazepine, cyclobenzaprine, dibenzazepines, diuretics, dextromethorphan, dopamine, other MAOIs (eg, phenelzine, selegiline, furazolidone, isocarboxazid), levodopa, methyldopa, methylphenidate, tryptophan, phenylalanine, tryptophan-, dopamine-, tyrosine-, or tyramine-containing foods, excess caffeine or chocolate. Meperidine within 3 weeks of tranylcypromine.


Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or unusual changes. Hyper- or hypotension. Cardiovascular or cerebrovascular disorders. Chronic headaches. Screen for bipolar disorder, mania, or hypomania. Depression. Epilepsy. Hyperthyroidism. Surgery. Discontinue if palpitations or headache occurs and 48hrs before to 24hrs after myelography. Avoid abrupt cessation. Monitor BP and observe patient frequently. May mask anginal pain or aggravate anxiety or agitation. Renal or hepatic impairment. Elderly. Debilitated. Pregnancy. Nursing mothers.


See Contraindications. Hypertensive crises with sympathomimetics, levodopa, and high-tyramine foods (eg, cheese, salami, chocolate, wine, beer, pickled herring, chicken livers, yeast extract, yogurt, broad beans). Caution with antidiabetic agents, antiparkinson agents, disulfiram. Potentiates CNS depressants, antihypertensives. Psychosis with dextromethorphan. Circulatory collapse, coma, death with meperidine. Do not start within 5 wks of fluoxetine, or 2 wks of sertraline, paroxetine, bupropion or citalopram, or 1 wk of venlafaxine discontinuance.

Pharmacological Class:


Adverse Reactions:

Orthostatic hypotension, hypertensive crises, headache, CNS overstimulation, seizures, changes in blood sugar, drowsiness, dry mouth, GI disturbances, tachycardia, anorexia, impotence, rash, hepatitis, edema, hepatotoxicity.

How Supplied:


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