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Drug Details

PARNATE

• Drug Class Description
  Monoamine-oxidase inhibitors (MAOIs, antidepressants).
• Generic Name
  Tranylcypromine Goldshield has confirmed that there are no availability problems with Parnate and it is widely available through UK wholesalers (July 2000).
• Presentation
  Tablets, tranylcypromine (as sulphate) 10 mg .
• Description
  Red s-c tablets marked SKF.
• Indications
  

  Depression.

• Adult Dosage
  

  Initially 1 twice daily, increasing if necessary after one week, to 1 three times daily.

  Maintenance, usually 1 daily.

• Child Dosage
  Not recommended.
• Contra Indications
  

  History of liver disease, abnormal liver function tests, blood dyscrasias, cardiac decompensation, congestive heart failure, cerebrovascular disease, phaeochromocytoma, hyperthyroidism. Pregnancy and lactation.

• Special Precautions
  Elderly patients, epilepsy.
• Interactions
  

  MAOIs may potentiate the actions of many drugs and foods, occasionally with a fatal result. Severe reactions may occur with indirectly acting sympathomimetic amines (especially amfetamine (amphetamine), methylphenidate, fenfluramine, ephedrine, levodopa and phenylpropanolamine), other MAOIs, dibenzazepine derivatives, tricyclic antidepressants, SSRIs and other 5HT reuptake inhibitors, pethidine and other narcotic analgesics, buspirone. The effects of barbiturates and possibly other hypnotics, alcohol, insulin and other hypoglycaemic agents may be enhanced and the incidence and severity of side effects of anticholinergics may be increased.

  Antihypertensive agents eg guanethidine, reserpine and methyldopa should be given with caution. The principal foods which should not be taken together with MAOIs are cheese, Bovril, Oxo or other meat extracts, broad bean pods, banana skins, Marmite or other yeast extracts, wines, beers or other alcohol, low-alcohol beers, lagers or wines, pickled herrings, flavoured textured vegetable proteins.

  Food that is not fresh. N.B: Allow sufficient time for clearance of drugs and their metabolites before initiating therapy with MAOIs eg up to 5 Conversely, allow at least 14 days after withdrawal of an MAOI before the use of foods or drugs known to cause reactions.

• Adverse Drug Reactions
  

  Severe hypertensive reactions with certain foods (see interactions). Insomnia, postural hypotension, dizziness, drowsiness, weakness and fatigue.

  Dry mouth, constipation, gastro- intestinal disturbances, blurred vision, difficulty in micturition. Ankle oedema. Skin rashes, blood disorders, jaundice, sexual disturbances and weight gain. Occasional induction of mania or confusional states.