PARNATE (Tranylcypromine)

PARNATE (Tranylcypromine)

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What is this medication? 

PARNATE (Tranylcypromine)
Antidepressant, Monoamine Oxidase Inhibitor

PARNATE (Tranylcypromine) is indicated for management of major depressive disorder.

Suicidal thoughts and behaviors:
Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors. PARNATE (Tranylcypromine) is not approved for use in pediatric patients.

Hypertensive crisis with significant tyramine use:
Excessive consumption of foods or beverages with significant tyramine content or the use of certain drugs with tranylcypromine or after tranylcypromine discontinuation can precipitate hypertensive crisis. Monitor blood pressure and allow for medication-free intervals between administration of tranylcypromine and interacting drugs. Instruct patients to avoid ingestion of foods and beverages with high tyramine content.”

How does this medication work? 

PARNATE (Tranylcypromine) is a nonhydrazine inhibitor of monoamine oxidase (MAO) in the central nervous system, which plays a major role in the catabolism of dopamine, epinephrine, and serotonin. 

How should I take this medication? 

Oral: Take 10-60mg per day in divided doses

How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same time each day unless otherwise directed, store at room temperature.

You Need to Avoid: Alcohol may increase toxic effects of MAO inhibitors and should be avoided.  Concurrent ingestion of foods rich in tyramine, dopamine, tyrosine, phenylalanine, tryptophan, or caffeine may cause sudden and severe high blood pressure (hypertensive crisis or serotonin syndrome).

Management: Avoid foods containing high amounts (>150 mg) of tyramine (aged or matured cheese, air-dried or cured meats including sausages and salamis; fava or broad bean pods, tap/draft beers, Marmite concentrate, sauerkraut, soy sauce, and other soybean condiments). Food’s freshness is also an important concern; improperly stored or spoiled food can create an environment in which tyramine concentrations may increase. Avoid these foods during and for 2 weeks after discontinuation of medication.

When discontinuing antidepressant treatment that has lasted for >3 weeks, gradually taper the dose to minimize withdrawal symptoms and detect reemerging symptoms. If intolerable withdrawal symptoms occur, resume the previously prescribed dose and/or decrease dose at a more gradual rate.

What should I watch for while using this medication? 

Before starting PARNATE (Tranylcypromine) make sure your physician is aware of any allergies, medications you currently take, if you have liver disease, diabetes, a history of drug abuse, a history of mania/hypomania, a seizure disorder, thyroid dysfunction, pheochromocytoma, blood dyscrasias, cerebrovascular/cardiovascular disorders, frequent recurrent headaches, or a history of suicidal ideation. PARNATE (Tranylcypromine) use has been associated with rare but serious adverse events such as CNS depression, hypertensive crisis, hypotension, intracranial bleeding, and serotonin syndrome. PARNATE (Tranylcypromine)   has many drug interactions, so discuss any supplements, natural health products, or nonprescription medications with your prescriber/pharmacist prior to using.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C).  Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication? 

Edema, orthostatic hypotension, palpitations, tachycardia, agitation, anxiety, chills, dizziness, drowsiness, headache, insomnia, mania, myoclonus, numbness, paresthesia, restlessness, diaphoresis, urticaria, SIADH, abdominal pain, anorexia, constipation, diarrhea, nausea, xerostomia, sexual disorder, urinary retention, agranulocytosis, anemia, leukopenia, thrombocytopenia, muscle spasm, tremor, weakness, blurred vision, tinnitus

Note this is not a complete list of side effects for PARNATE (Tranylcypromine), only common ones.