Why is this medication prescribed?

Marplan is a brand name for the generic drug isocarboxazid. It is a medication that belongs to a class of drugs known as monoamine oxidase inhibitors (MAOIs). Marplan is primarily prescribed to treat certain mood disorders, particularly major depressive disorder (MDD) and atypical depression. It may be used when other antidepressant medications have not been effective or when a healthcare provider believes it is the most suitable treatment option for a specific patient.

How should this medicine be used?

Here are some important guidelines for how Marplan should be used:

• Dosage: The dosage of Marplan can vary depending on the individual’s condition and response to the medication. It is essential to follow your healthcare provider’s instructions regarding the dosage. The initial dosage is typically low and gradually increased to achieve the best therapeutic effect.
• Frequency: Marplan is usually taken orally, and the typical dosing frequency is 2 to 4 times per day. Your doctor will determine the specific dosing schedule that works best for your condition.
• Food and dietary restrictions: One of the distinctive features of MAOIs like Marplan is that they require dietary restrictions to prevent potentially dangerous interactions. Patients taking Marplan must avoid foods and beverages that are high in tyramine, as consuming tyramine-rich foods while on an MAOI can lead to a significant increase in blood pressure. These foods include aged cheeses, certain meats (e.g., aged or fermented), alcohol, fermented soy products, and certain yeast extracts. Your doctor or a registered dietitian can provide you with a complete list of foods to avoid.
• Medication interactions: Marplan can interact with other medications, including over-the-counter drugs and prescription medications. Inform your healthcare provider about all the medications you are taking to ensure there are no potentially harmful drug interactions.
• Monitoring: Regularly scheduled appointments with your healthcare provider are essential when taking Marplan. This allows them to monitor your progress, adjust your dosage as needed, and address any potential side effects or concerns.
• Duration: Continue taking Marplan as prescribed by your healthcare provider, even if you start feeling better. Stopping the medication abruptly can lead to withdrawal symptoms or a return of depressive symptoms. The duration of treatment will vary from person to person.
• Side effects: Like all medications, Marplan can have side effects. Common side effects may include dizziness, drowsiness, dry mouth, constipation, and changes in appetite. More serious side effects are possible, so it’s crucial to report any unusual symptoms or side effects to your healthcare provider promptly.
• Safety precautions: Marplan may impair your ability to operate heavy machinery or drive, especially when you are just starting the medication. It’s important to avoid these activities until you know how Marplan affects you personally.

It is essential to use Marplan only under the supervision and guidance of a qualified healthcare provider, as it is a powerful medication with specific dietary and medication restrictions. Your healthcare provider will assess your individual situation and determine whether Marplan is an appropriate treatment for your condition. If you have any questions or concerns about Marplan or your treatment plan, be sure to discuss them with your healthcare provider.

Other uses for this medicine

While Marplan is primarily used to treat depression, in some cases, it may also be prescribed off-label for other conditions, such as social anxiety disorder or panic disorder. However, its use for these conditions would be at the discretion of your healthcare provider.

What special precautions should I follow?

Regarding special precautions for Marplan, here are some important considerations:

• Dietary Restrictions: One of the most critical precautions when taking Marplan is avoiding foods and beverages that contain high levels of tyramine. Consuming tyramine-rich foods can lead to a dangerous increase in blood pressure. Your healthcare provider or a registered dietitian can provide you with a comprehensive list of foods to avoid. These dietary restrictions must be strictly followed.
• Medication Interactions: Marplan can interact with a wide range of medications, including over-the-counter drugs and prescription medications. Inform your healthcare provider about all medications you are taking to prevent potentially harmful drug interactions.
• Medical History: Inform your healthcare provider of your complete medical history, including any past or current medical conditions and any history of substance abuse. It’s important to disclose this information to ensure the safe use of Marplan.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of taking Marplan with your healthcare provider. The safety of Marplan during pregnancy and breastfeeding is not well established, and alternative treatments may be considered.
• Side Effects: Be aware of potential side effects of Marplan, and report any unusual or severe side effects to your healthcare provider promptly. Common side effects may include dizziness, drowsiness, dry mouth, constipation, and changes in appetite.
• Suicidal Thoughts: Antidepressant medications, including Marplan, may increase the risk of suicidal thoughts or behaviors, particularly in young adults and adolescents. Close monitoring by a healthcare provider is essential, especially during the initial weeks of treatment.
• Regular Follow-Up: Regularly scheduled appointments with your healthcare provider are important to monitor your progress and adjust your treatment plan as needed.
• Abrupt Discontinuation: Do not stop taking Marplan abruptly without consulting your healthcare provider, as this can lead to withdrawal symptoms or a return of depressive symptoms. Tapering the medication is typically recommended when discontinuing treatment.

Always follow your healthcare provider’s instructions and guidance regarding the use of Marplan, and communicate openly about any concerns or questions you may have about your treatment plan.

What special dietary instructions should I follow?

Marplan users should adhere to specific dietary restrictions to avoid potentially dangerous interactions. Marplan is known to interact with foods and beverages that contain high levels of tyramine, a substance that can lead to a sudden and severe increase in blood pressure. Foods and beverages to avoid while taking Marplan include aged cheeses, cured meats (e.g., salami), soy sauce, certain beers and wines, and fermented or pickled products. A comprehensive list of restricted foods and beverages should be provided by your healthcare provider, and it’s crucial to follow these dietary guidelines strictly to prevent hypertensive crises.

What should I do if I forget a dose?

If you forget to take a dose of Marplan, follow these general guidelines:

• If you forget to take a dose of Marplan, take it as soon as you remember.
• However, if it’s close to the time for your next dose, skip the missed dose and go back to your regular dosing schedule.
• Never take two doses at the same time to make up for a missed dose.

What side effects can this medication cause?

Marplan (isocarboxazid) is a medication known as a monoamine oxidase inhibitor (MAOI) and is primarily prescribed for the treatment of depression. Like all medications, Marplan can cause side effects. Some of the common and less common side effects associated with Marplan include:

• Dizziness: Many people experience dizziness when taking Marplan, especially when getting up from a sitting or lying position. This can increase the risk of falls, so be cautious when moving around.
• Drowsiness: Marplan may cause drowsiness or sedation. Avoid activities that require alertness, such as driving or operating heavy machinery, until you know how the medication affects you.
• Dry Mouth: Some individuals may experience dry mouth while taking Marplan. Maintaining good oral hygiene and staying hydrated can help alleviate this side effect.
• Changes in Appetite: Marplan can lead to changes in appetite, which may result in weight gain or loss. Monitoring your eating habits and discussing any significant changes with your healthcare provider is important.
• Constipation: Constipation is a possible side effect of Marplan. Maintaining a diet rich in fiber and staying well-hydrated can help alleviate this issue.
• Insomnia or Sleep Disturbances: While some people experience drowsiness with Marplan, others may have difficulty falling asleep or staying asleep. Discuss any sleep-related issues with your healthcare provider.
• Nausea and Vomiting: Nausea and vomiting can occur in some individuals taking Marplan. Taking the medication with food or as directed by your healthcare provider may help reduce these symptoms.
• Hypertensive Crisis: This is a severe side effect that can occur if you consume foods or beverages containing high levels of tyramine while taking Marplan. Hypertensive crisis can lead to a dangerous increase in blood pressure and may result in symptoms like severe headache, palpitations, chest pain, and even life-threatening complications. This is why strict dietary restrictions are essential when on Marplan.
• Serotonin Syndrome: Although less common, Marplan, like other antidepressants, can increase serotonin levels in the brain and potentially lead to serotonin syndrome. Symptoms may include confusion, restlessness, rapid heartbeat, fever, muscle stiffness, and tremors. Seek immediate medical attention if you experience these symptoms.
• Allergic Reactions: Rarely, Marplan can cause allergic reactions, which may manifest as skin rash, itching, swelling, severe dizziness, or difficulty breathing. Seek immediate medical help if you suspect an allergic reaction.

It’s important to note that individual responses to medication can vary. Not everyone will experience these side effects, and some individuals may experience side effects that are not listed here. If you have any concerns about the side effects of Marplan or experience any unusual or severe symptoms while taking the medication, contact your healthcare provider promptly. They can help you manage side effects and adjust your treatment plan if necessary. Additionally, always follow your healthcare provider’s instructions and the dietary restrictions associated with Marplan to ensure safe and effective use of the medication.

What should I know about storage and disposal of this medication?

Storage:

• Store at Room Temperature: Keep Marplan at room temperature, away from excessive heat and moisture. Avoid storing it in the bathroom.
• Keep Out of Reach of Children: Ensure that the medication is stored in a place that is not accessible to children or pets. MAOIs like Marplan should be kept securely to prevent accidental ingestion.
• Protect from Light: Store Marplan in its original container, and protect it from light exposure.
• Follow Expiration Date: Check the expiration date on the medication packaging and do not use Marplan if it has expired.

Disposal:

• Consult Healthcare Provider: When you no longer need Marplan or it has expired, consult your healthcare provider or a local pharmacy for proper disposal instructions. Do not flush medications down the toilet unless instructed to do so, as this can potentially harm the environment.
• Take-Back Programs: Some communities or pharmacies may offer take-back programs or hazardous waste disposal sites for the safe disposal of medications. Check with your local authorities for available options.

In case of emergency/overdose

If you suspect an overdose or experience severe adverse effects while taking Marplan, seek immediate medical attention or contact a poison control center at 1-800-222-1222. Overdose symptoms may include:

• Severe headache
• Rapid heartbeat
• High blood pressure
• Nausea and vomiting
• Fever
• Muscle stiffness
• Agitation
• Hallucinations
• Loss of consciousness

What other information should I know?

• Follow Prescribed Dosage: Take Marplan exactly as prescribed by your healthcare provider. Do not increase or decrease the dosage without consulting your healthcare provider.
• Regular Monitoring: Attend scheduled follow-up appointments with your healthcare provider to monitor your progress and discuss any side effects or concerns.
• Dietary Restrictions: Strictly adhere to dietary restrictions while taking Marplan. Avoid foods and beverages that are high in tyramine, as consuming these items can lead to a dangerous increase in blood pressure.
• Medication Interactions: Inform your healthcare provider about all medications, including over-the-counter drugs and supplements, that you are taking. Marplan can interact with various medications, so it’s essential to disclose all substances you are using.
• Suicidal Thoughts: Be aware that antidepressant medications, including Marplan, may increase the risk of suicidal thoughts or behaviors, particularly in the early stages of treatment. Contact your healthcare provider immediately if you experience worsening depression or suicidal thoughts.
• Medical Alert Bracelet: If you are taking Marplan, consider wearing a medical alert bracelet or carrying a card indicating that you are on an MAOI. In case of an emergency, medical professionals should be aware of this to prevent potential drug interactions.

Always follow your healthcare provider’s instructions and recommendations for the safe and effective use of Marplan. It’s crucial to communicate openly about any concerns or questions you may have regarding your treatment plan.