Tranylcypromine

Question 1

Drug Class

Answer 1

Monoamine oxidase (MAO) inhibitors

Question 2

Active

Answer 2

Tranylcypromine

Question 3

Indications

Answer 3

Major depression

Question 4

Dose Range

Answer 4

20 – 40 mg daily in 2-3 divided doses

Question 5

SE’s

Answer 5

• insomnia (sometimes sedation)
• arousal
• postural hypotension
• dry mouth
• blurring of vision
• constipation
• anorgasmia
• impotence
• failure or ejaculation
• tremors, twitching, myoclonus
• weight gain
• SIADH (same as SSRI)

Question 6

Counselling

Answer 6

Labels: 1, 13, 16

• It is best to take your last dose of the day before 3 pm or you may have trouble sleeping at night.
• Avoid foods containing tyramine while taking this medicine and for 2 weeks after stopping treatment. Preferably eat fresh or fresh frozen foods, and avoid matured or out of date cheese, fermented or matured or aged meat products (eg salami), protein extracts, yeast extracts (eg Vegemite®) and soy bean extracts (eg tofu, miso) as these foods contain tyramine. Other foods that may contain amines include broad bean pods, sauerkraut, pickled herring and some alcoholic drinks. Make sure you have a detailed list.
• Stop taking it if experience severe headaches or palpitations and seek urgent medical advice.
• This medicine may cause drowsiness and increase the effects of alcohol; do not drive or operate machinery if you are affected.
• You may feel dizzy on standing when taking this medicine. Get up gradually from sitting or lying to minimise this effect; sit or lie down if you become dizzy.
• Avoid cold and flu products containing pseudoephedrinen phenyephrine and dextromethorphan.
• May interact with many medications; speak to you doctor/pharmacist before starting or stopping any medications including OTCs.

Question 7

Monitoring

Answer 7

• increased suicidal thoughts and behaviour can occur soon after starting antidepressants, particularly in young people; monitor patients frequently and carefully early in treatment.
• BP
• Hepatic function