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phenelzine (Nardil, Sinerval)

Tradename: Nardil. (phenelzine sulfate) Indications: - treatment of atypical, non-endogenous or neurotic depression in patients who do not respond to traditional antidepressants - bulimia nervosa Contraindications: 1) pheochromocytoma 2) hepatic disease 3) renal insufficiency 4) cerebrovascular defect 5) cardiovascular disease Dosage: 1) start 15 mg PO TID 2) after 2-6 weeks, decrease to 15 mg/day, or less in divided doses 3) avoid bedtime dosing Tabs: 15 mg. Pharmacokinetics: 1) onset of action: may take 2-4 weeks 2) eliminated in urine 3) may have therapeutic effects & produce drug interactions for 2 weeks after discontinuation Adverse effects: 1) common (> 10%) - orthostatic hypotension, blurred vision, drowsiness, weakness, trembling, sexual dysfunction 2) less common (1-10%) - diarrhea, nervousness, tachycardia, peripheral edema, anorexia, dry mouth, constipation, chills 3) uncommon (< 1%) - hepatitis, parkinsonism, leukopenia 4) other [2] - hypertensive crisis may occur with tyramine-containing foods Drug interactions: 1) guanethidine, reserpine, tyramine, tryptophan, caffeine in combination may result in hypertensive crisis 2) selective serotonin reuptake inhibitors#, tricyclic antidepressants, trazodone, dextromethorphan, sympathomimetics, meperidine, tramadol, buspirone in combination may result in serotonin syndrome 3) disulfiram 4) antihypertensive agents * a 2 week washout period is recommended prior to use of any of these agents # a 6 week washout is recommended after discontinuation of fluoxetine Mechanism of action: 1) inhibits monoamine oxidase 2) increases concentration of epinephrine, norepinephrine, dopamine & serotonin

Interactions

drug interactions drug adverse effects (more general classes)

General

monoamine oxidase [MAO] inhibitor

Properties

MISC-INFO: elimination route LIVER pregnancy-category C safety in lactation ?

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  3. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  4. Deprecated Reference