Formulary
Tranylcypromine: Indications, Dosing, Side Effects and Interactions
For all monoamine-oxidase inhibitors MAOIs inhibit monoamine oxidase, thereby causing an accumulation of amine neurotransmitters.
MedNext Academy | 3 min read
Tranylcypromine: 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 10 mg twice daily, dose to be taken at a time no later than 3 p.m, dose may be increased if necessary after 1 week, increased if necessary to 30 mg daily in divided doses, 10 mg to be taken in the morning and 20 mg to be taken in the afternoon, doses above 30 mg daily under close supervision only; maintenance 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 Contra-indications For tranylcypromine History of hepatic disease; hyperthyroidism
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 tranylcypromine Rare or very rare Hepatocellular injury Frequency not known Chest pain; diarrhoea; drug dependence; extrasystole; flushing; hypertension; hypomania; mydriasis; pain; pallor; photophobia; sleep disorder; throbbing headache
Interactions
**Other interactions (2):**
- Antidepressants: The occurrence of elevated blood pressure in patients receiving buspirone and monoamine oxidase inhibitors (phenelzine and tranylcypromine) has been reported.
- Generally, an interval of 14 days is recommended for switching from an irreversible MAO inhibitor to moclobemide (e.g.
Pregnancy
For all monoamine-oxidase inhibitors Increased risk of neonatal malformations-manufacturer advises avoid unless there are compelling reasons.
Breast feeding
Present in milk in animal studies.
Hepatic impairment
For all monoamine-oxidase inhibitors In general, manufacturers advise avoid.
Medicinal forms
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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