Formulary
Isocarboxazid: Indications, Dosing, Side Effects and Interactions
For all monoamine-oxidase inhibitors MAOIs inhibit monoamine oxidase, thereby causing an accumulation of amine neurotransmitters.
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Isocarboxazid: Indications, Dosing, Side Effects and Interactions
For all monoamine-oxidase inhibitors MAOIs inhibit monoamine oxidase, thereby causing an accumulation of amine neurotransmitters.
Drug action
For all monoamine-oxidase inhibitors MAOIs inhibit monoamine oxidase, thereby causing an accumulation of amine neurotransmitters.
Indications and dose
**Depressive illness**
- **Adult** (By Mouth): Initially 30 mg daily until improvement occurs, initial dose may be given in single or divided doses, dose may be increased if necessary after 4 weeks, increased if necessary up to 60 mg daily for 4-6 weeks, dose to be increased under close supervision only, then reduced to 10-20 mg daily, usual maintenance dose, but up to 40 mg daily may be required.
- **Elderly** (By Mouth): 5-10 mg daily.
Cautions
For all monoamine-oxidase inhibitors Acute porphyrias ; avoid in agitated patients; blood disorders; cardiovascular disease; concurrent electroconvulsive therapy; diabetes mellitus; elderly (great caution); epilepsy; severe hypertensive reactions to certain drugs and foods; surgery
Contraindications
For all monoamine-oxidase inhibitors Cerebrovascular disease; not indicated in manic phase; phaeochromocytoma; severe cardiovascular disease
Side effects
For all monoamine-oxidase inhibitors Frequency not known Akathisia; anxiety; appetite increased; arrhythmia; asthenia; behaviour abnormal; blood disorder; confusion; constipation; dizziness; drowsiness; dry mouth; dysuria; hallucination; headache; hyperhidrosis; insomnia; jaundice; nausea; paraesthesia; peripheral neuritis; postural hypotension (more common in elderly); reflexes increased; skin reactions; suicidal behaviours; tremor; vision blurred; vomiting; weight increased Side-effects, further information Risk of postural hypotension and hypertensive responses. Discontinue if palpitations or frequent headaches occur. Side-effects For isocarboxazid Frequency not known Granulocytopenia; peripheral oedema; sexual dysfunction
Interactions
**Severe interactions:**
- Pethidine should not be given to patients receiving monoamine oxidase inhibitors as serious, potentially fatal reactions, including central excitation, muscle rigidity, hyperpyrexia, circulatory...
**Other interactions (16):**
- Like other monoamine oxidase inhibitors, Isocarboxazid potentiates the action of a number of drugs and foods.
- Patients being treated with a monoamine oxidase inhibitor should not receive indirectly-acting sympathomimetic agents such as amphetamines, metaraminol, fenfluramine or similar anorectic agents,...
- Patients should also be warned to avoid foodstuffs and beverages with a high tyramine content: mature cheeses (including processed cheeses), hydrolysed yeast or meat extracts, alcoholic beverages,...
- Broad bean pods (which contain levodopa) and banana skins may also present a hazard.
- Isocarboxazid should therefore be discontinued immediately upon the occurrence of palpitations or frequent headaches.
- Such reactions are less likely with morphine, but experience of the interaction of Isocarboxazid with narcotic analgesics other than pethidine is limited and extreme caution is therefore necessary...
Pregnancy
For all monoamine-oxidase inhibitors Increased risk of neonatal malformations-manufacturer advises avoid unless there are compelling reasons.
Breast feeding
Avoid.
Hepatic impairment
For all monoamine-oxidase inhibitors In general, manufacturers advise avoid.
Renal impairment
Use with caution. M
Medicinal forms
Suspension
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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