WARNING

Tranylcypromine is a medication primarily used to treat depression, especially when other antidepressants have failed. However, it belongs to a class of drugs called monoamine oxidase inhibitors (MAOIs), which can pose significant risks if not taken with caution:

• Hypertensive crisis: Tranylcypromine can interact dangerously with certain foods rich in tyramine (found in aged cheeses, cured meats, and some beverages), leading to a sudden and severe increase in blood pressure, potentially resulting in a hypertensive crisis. This can lead to stroke, heart attack, or death.
• Serotonin syndrome: Taking tranylcypromine with other medications that increase serotonin levels (such as SSRIs, SNRIs, or certain opioids) can lead to serotonin syndrome, a potentially life-threatening condition characterized by symptoms like confusion, agitation, rapid heart rate, high blood pressure, dilated pupils, muscle rigidity, and sweating.
• Drug interactions: Tranylcypromine can interact dangerously with a wide range of medications, including other antidepressants, decongestants, stimulants, and certain pain medications. These interactions can lead to serious side effects or reduce the effectiveness of either medication.
• Side effects: Tranylcypromine can cause various side effects, including dizziness, drowsiness, insomnia, headache, nausea, dry mouth, constipation, and sexual dysfunction. In some cases, it may also cause more serious side effects like liver toxicity or blood disorders.
• Withdrawal symptoms: Suddenly stopping tranylcypromine can lead to withdrawal symptoms such as flu-like symptoms, anxiety, agitation, confusion, and depression. It’s important to taper off the medication gradually under medical supervision to minimize these effects.

Due to these risks, tranylcypromine is usually prescribed when other treatments have failed, and it requires careful monitoring by a healthcare professional. Patients taking tranylcypromine should follow their doctor’s instructions closely, including adhering to a specific diet to avoid dangerous interactions with tyramine-containing foods.

Why is this medication prescribed?

Tranylcypromine is prescribed primarily to treat major depressive disorder (MDD), especially in cases where other antidepressants have not been effective. It belongs to a class of medications known as monoamine oxidase inhibitors (MAOIs), which work by increasing the levels of certain chemicals in the brain that help regulate mood.

How should this medicine be used?

Here’s how tranylcypromine is typically used:

• Dosage: The usual starting dose for tranylcypromine is 10 milligrams (mg) taken two to three times daily. However, your doctor may adjust the dose based on your response to the medication and any side effects you may experience. The maximum recommended daily dose is usually 60 mg.
• Administration: Tranylcypromine is usually taken orally, with or without food. It’s important to take it exactly as prescribed by your doctor.
• Duration of treatment: Treatment with tranylcypromine may continue for several weeks or months, depending on the severity of your depression and how well you respond to the medication. It’s essential to continue taking it even if you start to feel better, unless otherwise directed by your doctor.
• Monitoring: Your doctor will likely monitor your progress closely while you’re taking tranylcypromine, especially during the early stages of treatment. This may involve regular check-ups and possibly blood tests to monitor your liver function and blood cell counts.
• Dietary restrictions: One crucial aspect of taking tranylcypromine is adhering to a low-tyramine diet. Tyramine is a substance found in certain foods and beverages, and consuming too much of it while taking an MAOI like tranylcypromine can lead to a dangerous increase in blood pressure. Foods to avoid include aged cheeses, cured meats, certain fermented or pickled foods, and some alcoholic beverages. Your doctor or a dietitian can provide you with a list of foods to avoid and guidelines for managing your diet while taking tranylcypromine.

It’s important to follow your doctor’s instructions carefully when taking tranylcypromine and to report any side effects or concerns promptly. Additionally, do not stop taking tranylcypromine abruptly without consulting your doctor, as this can lead to withdrawal symptoms. If you have any questions or concerns about your medication regimen, be sure to discuss them with your healthcare provider.

Other uses for this medicine

Some of these off-label uses include:

• Treatment-resistant depression: Tranylcypromine may be prescribed when other antidepressant medications have been ineffective in treating depression.
• Anxiety disorders: There is some evidence to suggest that tranylcypromine may be beneficial in certain anxiety disorders, such as social anxiety disorder or panic disorder, although it is not typically considered a first-line treatment for these conditions.
• Bipolar depression: Tranylcypromine may be used in combination with other medications to treat depressive episodes in bipolar disorder, particularly in cases where other treatments have not been effective.
• Obsessive-compulsive disorder (OCD): Tranylcypromine has been studied as a potential treatment for OCD, especially in cases where SSRIs (selective serotonin reuptake inhibitors) have not provided adequate relief.

What special precautions should I follow?

As for special precautions when taking tranylcypromine, consider the following:

• Avoid tyramine-rich foods: As mentioned earlier, tranylcypromine can interact dangerously with foods high in tyramine, leading to a potentially life-threatening increase in blood pressure. Avoid foods such as aged cheeses, cured meats, fermented or pickled foods, and certain alcoholic beverages. Your doctor or a dietitian can provide you with a comprehensive list of foods to avoid.
• Drug interactions: Tranylcypromine can interact with a wide range of medications, including other antidepressants, decongestants, stimulants, and certain pain medications. Inform your doctor about all medications, supplements, and herbal remedies you are taking before starting tranylcypromine to avoid potentially dangerous interactions.
• Medical conditions: Inform your doctor about any medical conditions you have, especially if you have a history of hypertension, heart disease, liver or kidney problems, seizures, or bipolar disorder. Tranylcypromine may not be suitable for individuals with certain medical conditions, or dosage adjustments may be necessary.
• Pregnancy and breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of taking tranylcypromine with your doctor. The use of tranylcypromine during pregnancy or breastfeeding should be carefully considered, as it may pose risks to the developing fetus or nursing infant.
• Monitoring: Your doctor will likely monitor your progress closely while you’re taking tranylcypromine, especially during the early stages of treatment. This may involve regular check-ups and possibly blood tests to monitor your liver function and blood cell counts.

By following these precautions and working closely with your healthcare provider, you can help ensure the safe and effective use of tranylcypromine for your specific condition.

What special dietary instructions should I follow?

Special dietary instructions for Tranylcypromine include:

• Low-tyramine diet: Follow a diet low in tyramine to avoid interactions that could lead to a hypertensive crisis. Stick to fresh foods and avoid aged, fermented, or spoiled foods. Consult with your doctor or a dietitian for specific dietary guidelines.

What should I do if I forget a dose?

If you forget a dose of Tranylcypromine:

• Take the missed dose as soon as you remember: If you miss a dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for the missed one.
• Set reminders: To avoid missing doses, consider setting reminders or alarms to take Tranylcypromine at the same time each day.
• Contact your doctor if unsure: If you’re unsure about what to do after missing a dose, contact your doctor or pharmacist for guidance.

What side effects can this medication cause?

Tranylcypromine, like any medication, can cause side effects. Common side effects may include:

• Dry mouth: Feeling thirsty or having a dry sensation in the mouth.
• Dizziness: Feeling lightheaded or unsteady.
• Insomnia: Difficulty falling asleep or staying asleep.
• Headache: Pain or discomfort in the head.
• Nausea: Feeling sick to the stomach or experiencing the urge to vomit.
• Constipation: Difficulty passing stools or having infrequent bowel movements.
• Changes in sexual function: Such as decreased libido or difficulty achieving orgasm.
• Weight gain: Some individuals may experience weight gain while taking Tranylcypromine.

Less common but potentially serious side effects may include:

• Hypertensive crisis: An abrupt and severe increase in blood pressure, which can lead to symptoms such as severe headache, rapid heartbeat, chest pain, blurred vision, and confusion. This can occur if Tranylcypromine interacts with foods high in tyramine or certain medications.
• Serotonin syndrome: A potentially life-threatening condition characterized by symptoms such as agitation, confusion, rapid heart rate, high blood pressure, dilated pupils, muscle rigidity, and sweating. This can occur if Tranylcypromine is taken with other medications that increase serotonin levels.
• Liver toxicity: Rarely, Tranylcypromine can cause liver problems, which may manifest as jaundice (yellowing of the skin or eyes), dark urine, abdominal pain, or unusual fatigue.
• Blood disorders: Tranylcypromine may rarely affect blood cells, leading to conditions such as agranulocytosis (a severe reduction in white blood cells), thrombocytopenia (a low platelet count), or hemolytic anemia (breakdown of red blood cells).
• Allergic reactions: In rare cases, Tranylcypromine may cause allergic reactions such as rash, itching, swelling, dizziness, or difficulty breathing.

It’s important to report any unusual or concerning symptoms to your healthcare provider promptly. Your doctor can help you manage side effects and determine if Tranylcypromine is the right medication for you. Additionally, do not stop taking Tranylcypromine without consulting your doctor, as abruptly discontinuing the medication can cause withdrawal symptoms.

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

Storage and disposal of Tranylcypromine:

• Storage: Store Tranylcypromine at room temperature, away from moisture and heat. Keep it in its original container, tightly closed, and out of reach of children and pets.
• Disposal: Dispose of any unused or expired Tranylcypromine properly according to local regulations or guidelines. Do not flush medications down the toilet or pour them down the drain unless instructed to do so. Contact your pharmacist or local waste disposal company for information on how to safely dispose of Tranylcypromine.

In case of emergency/overdose

If you suspect an overdose of Tranylcypromine or experience symptoms such as severe headache, rapid heartbeat, confusion, hallucinations, seizures, or loss of consciousness, seek immediate medical attention or call your local poison control center. Be prepared to provide information about the medication and the amount ingested.

What other information should I know?

• Keep all appointments with your doctor for monitoring and dosage adjustments.
• Inform all healthcare providers involved in your care that you are taking Tranylcypromine, including dentists and pharmacists.
• Avoid alcohol while taking Tranylcypromine, as it may increase the risk of side effects.
• Do not drive or operate machinery until you know how Tranylcypromine affects you, as it may cause dizziness or drowsiness.
• If you are undergoing surgery, inform your surgeon or anesthesiologist that you are taking Tranylcypromine, as it may interact with certain anesthetic agents.
• Carry a medical alert card or wear a medical alert bracelet indicating that you are taking Tranylcypromine, in case of emergency situations.
• Do not take any other medications, including over-the-counter drugs and herbal supplements, without consulting your doctor first, as they may interact with Tranylcypromine.

It’s crucial to follow your doctor’s instructions carefully and to communicate any concerns or questions you have about Tranylcypromine with your healthcare provider.