WARNING

Nardil is a brand name for the medication phenelzine, which belongs to a class of drugs called monoamine oxidase inhibitors (MAOIs). While Nardil can be effective in treating certain mental health conditions, it also carries several risks and potential side effects. Here are some important risks associated with taking Nardil:

• Dietary restrictions: Nardil interacts with certain foods and beverages that contain high levels of tyramine, such as aged cheeses, cured meats, fermented foods, and certain wines. Consuming these substances while on Nardil can lead to a severe increase in blood pressure, potentially causing a hypertensive crisis.
• Drug interactions: Nardil can interact with various medications, including certain antidepressants, stimulants, opioids, and over-the-counter cold and cough medications. These interactions can result in a potentially life-threatening condition called serotonin syndrome, characterized by symptoms like confusion, rapid heart rate, fever, and seizures.
• Hypotension: Nardil can cause a drop in blood pressure, leading to symptoms like dizziness, lightheadedness, and fainting. This risk is especially significant when standing up or changing positions quickly.
• Central nervous system effects: Nardil may cause side effects affecting the central nervous system, including drowsiness, sedation, weakness, and difficulty concentrating. These effects can impair cognitive and motor function, affecting one’s ability to perform tasks requiring alertness.
• Psychological effects: Nardil may lead to changes in mood or behavior, including worsening depression, anxiety, or suicidal thoughts. It is essential to closely monitor any emotional changes while taking this medication.
• Other side effects: Nardil can cause various other side effects, such as dry mouth, constipation, blurred vision, sexual dysfunction, weight gain, and insomnia.

Due to these risks, Nardil is typically prescribed when other treatment options have failed or are unsuitable. It is crucial to work closely with a healthcare professional who can monitor your condition and manage any potential risks while taking this medication.

Why is this medication prescribed?

Nardil (phenelzine) is prescribed primarily for the treatment of depression, specifically major depressive disorder (MDD). It is classified as an antidepressant and belongs to a class of medications known as monoamine oxidase inhibitors (MAOIs). Nardil works by inhibiting the enzyme monoamine oxidase, which helps regulate the levels of certain neurotransmitters in the brain, such as serotonin, norepinephrine, and dopamine.

Here are some reasons why Nardil may be prescribed:

• Major depressive disorder: Nardil is commonly used to treat moderate to severe depression that has not responded to other antidepressant medications. It may be an option when other classes of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs), have not been effective.
• Treatment-resistant depression: Nardil may be prescribed for individuals who have not responded well to multiple antidepressant medications or who have recurrent episodes of depression that do not remit with standard treatment.
• Anxiety disorders: Nardil has also been found to be effective in treating certain anxiety disorders, such as social anxiety disorder (social phobia) and panic disorder.

How should this medicine be used?

Here are some general guidelines for using Nardil:

• Dosage: The initial dosage and subsequent adjustments will be determined by your healthcare provider based on your specific condition, response to treatment, and tolerability. It is important to take the prescribed dose as directed and not to alter the dosage without consulting your doctor.
• Administration: Nardil is usually taken orally, with or without food. The tablets should be swallowed whole with water and should not be crushed, chewed, or dissolved.
• Timing: Your healthcare provider will provide instructions on the frequency and timing of doses. It is typically recommended to take Nardil two to three times a day, evenly spaced throughout the day, to maintain a consistent level of the medication in your system.
• Compliance: It is important to take Nardil regularly and consistently for it to be effective. If you miss a dose, take it as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
• Duration: Continue taking Nardil as prescribed, even if you start feeling better. Abruptly stopping the medication can lead to withdrawal symptoms or a recurrence of your symptoms. If you and your doctor decide to discontinue Nardil, a gradual tapering-off process may be necessary.
• Monitoring: Regularly attend follow-up appointments with your healthcare provider to monitor your response to Nardil, assess any side effects, and make any necessary adjustments to your treatment plan.

It is crucial to communicate openly with your doctor throughout your Nardil treatment, reporting any changes in your condition, side effects, or concerns you may have. Your healthcare provider will provide personalized guidance based on your individual needs and circumstances.

Other uses for this medicine

In addition to its primary use in treating depression, there is limited evidence to suggest that Nardil may be helpful for other conditions. However, it is important to note that the off-label use of Nardil should only be considered under the guidance of a qualified healthcare professional.

What special precautions should I follow?

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

• Dietary restrictions: Nardil interacts with foods and beverages containing high levels of tyramine, such as aged cheeses, cured meats, fermented foods, and certain wines. Consuming these substances while taking Nardil can lead to a severe increase in blood pressure, potentially causing a hypertensive crisis. It is crucial to adhere strictly to the dietary restrictions advised by your healthcare provider.
• Drug interactions: Nardil can interact with various medications, including other antidepressants, stimulants, opioids, and over-the-counter cold and cough medications. These interactions can result in a potentially life-threatening condition called serotonin syndrome. Inform your doctor about all the medications, supplements, and herbal products you are taking to avoid harmful interactions.
• Medical conditions: Inform your healthcare provider about any pre-existing medical conditions, including cardiovascular disease, liver disease, kidney disease, diabetes, and epilepsy. Nardil may require caution or dosage adjustments in these situations.
• Surgery and anesthesia: If you are scheduled for surgery, it is important to inform your surgeon and anesthesiologist that you are taking Nardil. The medication can interact with certain anesthetic agents, leading to severe reactions.
• Pregnancy and breastfeeding: The safety of Nardil during pregnancy and breastfeeding has not been well-established. Consult with your doctor if you are pregnant, planning to become pregnant, or breastfeeding before taking Nardil.
• Monitoring and side effects: Regular monitoring is essential while taking Nardil. Be aware of potential side effects, including changes in mood, behavior, blood pressure, dizziness, sedation, and others. Report any concerning symptoms to your healthcare provider promptly.

It is crucial to have open and regular communication with your healthcare provider while taking Nardil. They can provide personalized guidance and ensure that the benefits of the medication outweigh the potential risks in your specific situation.

What special dietary instructions should I follow?

When taking Nardil, it is important to follow specific dietary instructions to avoid potential interactions with certain foods and beverages. These interactions can lead to a dangerous increase in blood pressure. Here are some dietary precautions to observe:

• Avoid high-tyramine foods: Tyramine is a naturally occurring substance found in various foods. When combined with MAOIs like Nardil, it can cause a sudden and severe increase in blood pressure. Foods high in tyramine include aged cheeses, cured or smoked meats, fermented or pickled foods, sauerkraut, soy sauce, and certain types of beer and wine.
• Be cautious with certain beverages: Avoid consuming large amounts of caffeine-containing beverages like coffee, tea, or energy drinks while taking Nardil. Excessive caffeine intake can also contribute to increased blood pressure.
• Read food labels carefully: Some foods, such as certain sauces, condiments, and processed products, may contain hidden sources of tyramine. Carefully read food labels and avoid products that list tyramine-rich ingredients.

What should I do if I forget a dose?

If you miss a dose of Nardil, you should take it as soon as you remember. However, if it is close to the time for your next scheduled dose, it is usually advised to skip the missed dose and continue with your regular dosing schedule. It is important not to double up on doses unless explicitly instructed to do so by your healthcare provider. If you have any concerns or questions about missed doses, it’s best to consult your healthcare professional for personalized advice.

What side effects can this medication cause?

Like other medications, Nardil can cause side effects. Some of the common side effects associated with Nardil include:

• Dry mouth
• Drowsiness or sedation
• Dizziness or lightheadedness
• Blurred vision
• Constipation
• Difficulty urinating
• Changes in sexual desire or performance
• Weight gain
• Insomnia or difficulty sleeping
• Headache
• Nervousness or anxiety
• Tremors
• Nausea or upset stomach
• Increased sweating
• Low blood pressure when standing up quickly (orthostatic hypotension)

In some cases, Nardil can also cause more serious side effects that require immediate medical attention. These less common but potentially severe side effects may include:

• Hypertensive crisis: Nardil can interact with certain foods, beverages, and medications, leading to a sudden and dangerous increase in blood pressure. Symptoms of a hypertensive crisis include severe headache, palpitations, chest pain, neck stiffness or soreness, nausea, vomiting, sweating, dilated pupils, and rapid breathing. If you experience these symptoms, seek emergency medical assistance.
• Serotonin syndrome: Nardil can increase serotonin levels in the body, and in rare cases, this can lead to a condition called serotonin syndrome. Symptoms may include agitation, hallucinations, rapid heartbeat, high fever, tremors, muscle stiffness or twitching, coordination problems, and diarrhea. If you experience these symptoms, seek immediate medical attention.
• Allergic reactions: Some individuals may experience an allergic reaction to Nardil, characterized by symptoms such as rash, itching, swelling, severe dizziness, or difficulty breathing. If you have any signs of an allergic reaction, seek immediate medical help.

It is important to note that this is not an exhaustive list of side effects, and individual experiences may vary. If you have concerns about potential side effects or if you experience any unusual or bothersome symptoms while taking Nardil, it is recommended to consult your healthcare professional for further evaluation and guidance. They can provide you with more detailed information and determine the best course of action based on your specific situation.

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

• Storage: Store Nardil at room temperature, away from excessive heat, moisture, and light. Keep the medication in its original container, tightly closed, and out of reach of children or pets.
• Disposal: Dispose of Nardil properly and in accordance with local regulations. Do not flush it down the toilet or pour it down the drain unless specifically instructed to do so. It is recommended to consult your healthcare professional, pharmacist, or local waste disposal authority for guidance on safe disposal methods. They can provide information on medication take-back programs or other appropriate disposal options.

In case of emergency/overdose

• In case of an overdose or emergency, call your local emergency services right away.
• Symptoms of an overdose may include restlessness, agitation, hallucinations, severe headache, fast or irregular heartbeat, tremors, sweating, dilated pupils, or seizures. Prompt medical attention is crucial.

What other information should I know?

• Inform your doctor about your complete medical history, including any other medications, supplements, or herbal products you are taking, to avoid potential drug interactions.
• Nardil can take several weeks to show its full effect, so it is important to continue taking it as prescribed, even if you initially don’t notice improvements.
• Abruptly stopping Nardil can cause withdrawal symptoms. If you need to discontinue the medication, your doctor will provide appropriate instructions for tapering the dose gradually.

Remember, this information is not exhaustive, and it is crucial to consult your prescribing physician or pharmacist for personalized advice, as they have access to your complete medical history and can provide the most accurate information regarding your specific situation.