WARNING

Phenelzine is a monoamine oxidase inhibitor (MAOI) used as an antidepressant. While it can be effective for treating certain conditions, it also comes with potential risks and side effects. Here’s a brief overview:

• Hypertensive Crisis: One of the most significant risks of taking Phenelzine is the potential for a hypertensive crisis. This is a severe increase in blood pressure that can lead to a medical emergency. This risk is particularly high when consuming foods or medications containing tyramine, a substance that normally gets broken down by monoamine oxidase.
• Dietary Restrictions: Due to the risk of hypertensive crisis, individuals taking Phenelzine must follow a strict diet that avoids foods high in tyramine, such as aged cheeses, certain meats, and fermented products.
• Drug Interactions: Phenelzine can interact with a variety of medications and substances, potentially leading to dangerous reactions. These interactions may occur with other antidepressants, sympathomimetic drugs, and certain over-the-counter medications.
• Serotonin Syndrome: Phenelzine use has been associated with serotonin syndrome, a potentially life-threatening condition that results from an excess of serotonin. This syndrome can occur when MAOIs are combined with other medications that increase serotonin levels, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).
• Adverse Reactions: Like other antidepressants, Phenelzine can cause various side effects, including dizziness, insomnia, weight gain, and sexual dysfunction.
• Withdrawal Effects: Abruptly stopping Phenelzine can lead to withdrawal effects, including mood swings, irritability, and flu-like symptoms.

It’s crucial for individuals considering or currently taking Phenelzine to discuss their medical history, current medications, and dietary habits with their healthcare provider. Due to the potential risks and complications associated with Phenelzine, it is typically prescribed when other antidepressant options have proven ineffective. Regular monitoring and follow-up with a healthcare professional are essential to manage these risks effectively.

Why is this medication prescribed?

Phenelzine is a medication that belongs to a class of drugs known as monoamine oxidase inhibitors (MAOIs). It is primarily prescribed for the treatment of depression, particularly when other antidepressant medications have not been effective. Phenelzine works by inhibiting the activity of an enzyme called monoamine oxidase, which plays a role in the breakdown of certain neurotransmitters, such as serotonin, norepinephrine, and dopamine. By inhibiting this enzyme, phenelzine increases the levels of these neurotransmitters in the brain, which is believed to help alleviate symptoms of depression.

How should this medicine be used?

Here are general guidelines for the use of phenelzine:

• Dosage: The dosage of phenelzine can vary depending on the individual’s response to the medication and the severity of the condition being treated. It is important to follow the prescribed dosage and not to adjust it without consulting a healthcare professional.
• Administration: Phenelzine is usually taken orally in divided doses with meals. This helps to reduce the risk of certain side effects and complications, such as hypertensive crisis, which can occur if the medication interacts with certain foods.
• Dietary Restrictions: Individuals taking phenelzine must adhere to a low-tyramine diet to avoid the risk of a hypertensive crisis. This involves avoiding foods high in tyramine, such as aged cheeses, certain meats, fermented products, and some alcoholic beverages.
• Drug Interactions: It’s essential to inform healthcare providers about all medications, including over-the-counter drugs and herbal supplements, being taken concurrently with phenelzine. There are significant interactions with other antidepressants, sympathomimetic drugs, and medications containing dextromethorphan.
• Monitoring: Regular check-ups and monitoring by a healthcare professional are necessary to assess the effectiveness of the medication, manage potential side effects, and monitor for any adverse reactions.
• Discontinuation: It’s important not to stop taking phenelzine abruptly, as this can lead to withdrawal effects. A healthcare provider will provide guidance on how to gradually taper off the medication if it needs to be discontinued.

Individuals considering or prescribed phenelzine should discuss their medical history, current medications, and any concerns with their healthcare provider. Due to the potential risks associated with phenelzine, it is typically prescribed when other antidepressant options have proven ineffective, and its use requires careful monitoring.

Other uses for this medicine

Here are some of the potential alternative uses:

• Bipolar Disorder: In some cases, phenelzine may be prescribed for individuals with bipolar disorder, particularly for the depressive phase. However, mood stabilizers are generally preferred for long-term management of bipolar disorder.
• Social Anxiety Disorder (Social Phobia): Phenelzine has been studied for its potential effectiveness in social anxiety disorder. It may be considered when other treatment options have not provided relief.
• Panic Disorder: Some studies have suggested that phenelzine may be effective in the treatment of panic disorder, especially when other medications are not well-tolerated or are ineffective.

What special precautions should I follow?

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

• Dietary Restrictions: A major concern with phenelzine is the risk of a hypertensive crisis, which can be triggered by consuming foods high in tyramine. Patients taking phenelzine should follow a low-tyramine diet, which involves avoiding certain foods and beverages, such as aged cheeses, cured meats, fermented products, and some alcoholic beverages.
• Drug Interactions: Phenelzine has significant interactions with other medications. It should not be taken concurrently with other antidepressants, sympathomimetic drugs, certain narcotics, and medications containing dextromethorphan. Inform your healthcare provider about all medications, including over-the-counter drugs and herbal supplements, that you are taking.
• Medical Conditions: Inform your healthcare provider of any medical conditions you have, especially those related to cardiovascular health, as phenelzine can affect blood pressure.
• Liver Disease: Phenelzine is metabolized by the liver, and individuals with liver disease may require dose adjustments or careful monitoring.
• Pregnancy and Breastfeeding: The safety of phenelzine during pregnancy and breastfeeding is not well established. Consult with your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding.

Always follow your healthcare provider’s instructions, attend regular check-ups, and report any unusual symptoms or side effects while taking phenelzine. It’s crucial to have open communication with your healthcare team to ensure safe and effective use of the medication.

What special dietary instructions should I follow?

• Low-Tyramine Diet: To prevent a hypertensive crisis, follow a low-tyramine diet. Avoid foods and beverages high in tyramine, such as aged cheeses, cured or fermented meats, pickled products, certain soy products, and certain alcoholic beverages (especially beer and red wine).
• Read Food Labels: Pay close attention to food labels, and be aware of the tyramine content in foods. Fresh and properly stored foods are generally safer.
• Limit Caffeine: Excessive caffeine intake may contribute to increases in blood pressure. Moderation in caffeine consumption is advisable.

What should I do if I forget a dose?

• Take It as Soon as You Remember: If you forget to take a dose of phenelzine, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
• Do Not Double Up: Do not take a double dose to make up for a missed one. Taking more than the prescribed amount can increase the risk of side effects.
• Consult Your Healthcare Provider: If you frequently forget doses or have questions about your medication schedule, consult your healthcare provider. They can provide guidance on how to manage missed doses and may adjust your treatment plan if necessary.

What side effects can this medication cause?

Phenelzine, like any medication, can cause side effects. It’s important to note that not everyone will experience these side effects, and their severity can vary. Common side effects of phenelzine include:

• Orthostatic Hypotension: A sudden drop in blood pressure when standing up, which can lead to dizziness or fainting.
• Drowsiness or Insomnia: Phenelzine may cause either drowsiness or difficulty sleeping.
• Weight Gain: Some individuals may experience weight gain while taking phenelzine.
• Dry Mouth: A common side effect that can be managed with good oral hygiene practices.
• Constipation: Phenelzine may cause constipation in some individuals.
• Sexual Dysfunction: Changes in libido and sexual function have been reported as side effects.
• Blurred Vision: Some people may experience blurred vision while taking phenelzine.
• Edema: Swelling, usually of the ankles or feet, may occur.
• Difficulty Urinating: In rare cases, difficulty urinating may be observed.
• Increased Appetite: Some individuals may experience an increase in appetite.

It’s important to be aware of more serious side effects that require immediate medical attention. These can include:

• Hypertensive Crisis: A severe increase in blood pressure, potentially leading to a medical emergency. This can occur if foods high in tyramine are consumed while taking phenelzine.
• Serotonin Syndrome: Although rare, phenelzine can, in some cases, lead to serotonin syndrome, especially when combined with other medications that increase serotonin levels.
• Allergic Reactions: Severe allergic reactions are rare but require immediate medical attention if they occur.
• Liver Problems: In rare cases, phenelzine may affect liver function.
• Blood Disorders: Phenelzine can, in rare instances, affect the blood cells, leading to conditions such as agranulocytosis.

It’s essential to report any unusual or severe side effects to your healthcare provider promptly. Additionally, if you experience symptoms of a hypertensive crisis, such as severe headache, rapid heartbeat, or chest pain, seek emergency medical attention.

Individuals considering or prescribed phenelzine should discuss potential side effects with their healthcare provider. The decision to use phenelzine should be based on a careful consideration of the risks and benefits, and regular follow-ups with a healthcare professional are crucial to monitor for side effects and adjust treatment as needed.

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

Storage and Disposal of Phenelzine:

• Storage:
  • Store phenelzine at room temperature, away from moisture and heat.
  • Keep the medication in its original container, tightly closed, and out of reach of children.
• Disposal:
  • Dispose of unused or expired medications properly. Do not flush them down the toilet or throw them in the trash.
  • Take them to a drug take-back program or follow specific disposal instructions provided by your pharmacist or local waste disposal facility.

In case of emergency/overdose

In case of an emergency or suspected overdose of phenelzine, seek medical attention immediately. Symptoms of overdose may include:

• Severe headache
• Blurred vision
• Confusion
• Seizures
• Agitation
• Hallucinations
• Rapid heartbeat

What other information should I know?

• Follow Healthcare Provider’s Instructions: Take phenelzine exactly as prescribed by your healthcare provider. Do not adjust the dosage or stop taking the medication without consulting your doctor.
• Regular Monitoring: Attend regular check-ups with your healthcare provider to monitor the effectiveness of the medication, address any concerns, and assess for potential side effects.
• Avoid Alcohol and Recreational Drugs: Limit or avoid the consumption of alcohol and recreational drugs, as they can interact with phenelzine and potentially lead to adverse effects.
• Inform Other Healthcare Providers: Inform all healthcare providers, including dentists and surgeons, about your use of phenelzine before any medical procedures.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of phenelzine with your healthcare provider.
• Avoid Tyramine-Rich Foods: Follow a low-tyramine diet to avoid a hypertensive crisis. Avoid foods and beverages high in tyramine, such as aged cheeses, cured meats, and certain alcoholic beverages.
• Notify Healthcare Provider of Side Effects: Report any unusual or severe side effects to your healthcare provider promptly.
• Drug Interactions: Inform your healthcare provider about all medications, including over-the-counter drugs and herbal supplements, that you are taking to avoid potential interactions.
• Medical Alert Bracelet: In some cases, especially if you are at risk for hypertensive crisis, wearing a medical alert bracelet may be recommended to inform emergency medical personnel about your medication.

Always consult your healthcare provider or pharmacist if you have specific questions about the storage, disposal, or usage of phenelzine. They can provide personalized guidance based on your medical history and individual circumstances.