Marplan
Marplan, the brand name for isocarboxazid, is a monoamine oxidase inhibitor (MAOI). It's used to treat depression in adults. But it's usually not the first choice for depression because of the risk of side effects. There are also certain foods to avoid and interactions with other medications. Marplan (isocarboxazid) comes as a tablet you take by mouth 2 to 4 times a day. The dosage is typically started low and is slowly raised based on how well it works and if you have side effects. Some side effects can include sleepiness, headaches, and a dry mouth.
What is Marplan (isocarboxazid)?
What is Marplan (isocarboxazid) used for?
How Marplan (isocarboxazid) works
Marplan (isocarboxazid) is a monoamine oxidase inhibitor (MAOI). It works by blocking a protein in the body called MAO. This prevents MAO from breaking down dopamine, serotonin, and norepinephrine in the brain.
By blocking MAO, Marplan (isocarboxazid) helps raise the levels of these chemicals in the brain. This helps regulate mood and treat symptoms of depression.
Drug facts
Side effects of Marplan (isocarboxazid)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dizziness (29%)
- Headache (15%)
- Dry mouth (9%)
- Constipation (7%)
- Nausea (6%)
- Sleep problems (5%)
Less Common Side Effects
- Sleepiness
- Tiredness
- Tremors
- Low blood pressure when standing up
- Anxiety
- Chills
- Sweating
- Diarrhea
Marplan (isocarboxazid) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts or behaviors
- Extremely high blood pressure: seizure, chest pain, severe headache, frequent headaches, confusion, blurry vision, anxiety, trouble breathing
- Serotonin syndrome: hallucinations, seizure, confusion, restlessness, shivering, sweating, high fever, headache, racing heart, muscle stiffness or twitching, tremor
The following Marplan (isocarboxazid) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
chills
cold sweats
confusion
difficult urination
dizziness, faintness, or lightheadedness when getting up from lying or sitting position
fainting
fast, irregular, pounding, or racing heartbeat or pulse
fear or nervousness
heavy feeling
increased need to urinate
passing urine more often
restlessness
shakiness in the legs, arms, hands, or feet
sudden jerky movements of the body
sweating
trembling or shaking of the hands or feet
trouble sitting still
Incidence not known
Agitation
burning while urinating
change in consciousness
decrease in frequency of urination
decrease in urine volume
decreased urine output
difficulty in passing urine (dribbling)
dizziness
false or unusual sense of well-being
headache
hostility
irritability
loss of bladder control
loss of consciousness
muscle twitching
need to keep moving
numbness or tingling of the hands, feet, or face
rapid weight gain
seeing, hearing, or feeling things that are not there
seizures
shakiness and unsteady walk
stupor
swelling of the face, ankles, or hands
unsteadiness, trembling, or other problems with muscle control or coordination
unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Decreased interest in sexual intercourse
drowsiness
inability to have or keep an erection
loss in sexual ability, desire, drive, or performance
relaxed and calm
sleepiness
trouble sleeping
unable to sleep
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
Incidence not known
Black tongue
blurred vision
change in vision
impaired vision
increased sensitivity of the skin to sunlight
raised, dark red, wart-like spots on the skin, especially when used on the face
redness or other discoloration of the skin
severe sunburn
skin rash
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Marplan (isocarboxazid)
Pros
- Possible option for depression when other antidepressants haven't worked well
- Taken by mouth
- Can take with or without food
Cons
- Not a first-choice option because it can have serious side effects
- Can interact with other medications and foods
- Taken multiple times in a day
Pharmacist tips for Marplan (isocarboxazid)
- Marplan (isocarboxazid) can take a few weeks to start working. If you don't start to feel any better after 3 to 6 weeks, talk to your prescriber. There might be other options for you.
- Take Marplan (isocarboxazid) with or without food. If the medication is hurting your stomach, try taking it with food next time to help. There are some foods you should avoid to keep your blood pressure from getting way too high.
- Talk to your prescriber about what foods to avoid while you're Marplan (isocarboxazid). Some foods, like aged cheese and cured meats, can raise your risk of very high blood pressure that needs medical attention. Get help right away if you have chest pain, a severe headache, confusion, or blurry vision. These can be signs of dangerously high blood pressure.
- Avoid drinking alcohol and avoid drinking too much caffeine while taking Marplan (isocarboxazid). Alcohol can make you feel sleepier and dizzier. Some drinks, like beer, liquors, and too much caffeine, can raise your risk of very high blood pressure. Talk to your prescriber if you can't fully avoid alcohol or if you need help cutting back on caffeine.
- Don't drive or do anything that needs your full attention until you know how Marplan (isocarboxazid) affects you. This medication can lower your blood pressure, which can make you feel dizzy or faint. This can lead to accidents if you're not careful.
- Tell your healthcare team about all the prescription and over-the-counter medications you take. Marplan (isocarboxazid) can interact with many medications, which can be unsafe. Your care team can check that your medications are safe to take together.
- Don't lower your dose or stop taking Marplan (isocarboxazid) without talking to your prescriber first. Doing this too quickly can cause bothersome withdrawal symptoms. Some include headache, upset stomach, muscle aches, trouble sleeping, and anxiety. Follow your prescriber's instructions to slowly lower your dose over time to stop the medication safely.
Common questions about Marplan (isocarboxazid)
Marplan (isocarboxazid) is still available according to the manufacturer. Ask your pharmacist or prescriber if you have any questions about availability.
Yes, Marplan (isocarboxazid) is a monoamine oxidase inhibitor (MAOI) that's used to treat depression. It works by stopping MAO proteins from working. This raises the levels of certain chemicals in the brain that help regulate mood. MAOIs like Marplan (isocarboxazid) aren't usually the first choice for depression. This is because they have a lot of side effects, drug interactions, and dietary restrictions.
Marplan (isocarboxazid) can take some time to start working. Some people might feel a little better within a week or two. But it usually takes 3 to 6 weeks or more to see the full effect of the medication on your mood. Try to be patient and keep taking Marplan (isocarboxazid) every day, even if you don't feel a difference right away. Ask your prescriber if you have questions about how long it might take to feel better.
You should avoid foods high in tyramine while taking Marplan (isocarboxazid). These include aged cheese; yogurt; cured meats; soy sauce; and smoked, pickled, or fermented food. These foods have a natural substance called tyramine. When you take this medication, your body can't break down tyramine. Too much tyramine can cause your blood pressure to go up too much. This dangerous rise in blood pressure is called hypertensive crisis. It's serious and can lead to symptoms like severe headache, vision changes, and trouble breathing. Talk to your care team if you have a hard time avoiding these types of foods. They might switch you to a different medication.
Your prescriber might consider an MAOI like Marplan (isocarboxazid) for anxiety. But it's not a first-choice option and it's not FDA approved for anxiety. Also keep in mind that anxiety can be a side effect of Marplan (isocarboxazid). If you have depression and anxiety, talk to your prescriber about your treatment options.
MAOIs like Marplan (isocarboxazid) aren't recommended during pregnancy. It's not known how safe they are for pregnant people and their babies. If you become pregnant or are planning to become pregnant while taking this medication, tell your prescriber. They can talk to you about other options. If you become pregnant while taking Marplan (isocarboxazid), it's a good idea to join the National Pregnancy Registry for Psychiatric Medications. This helps researchers learn more about the medication's effects during pregnancy. You can join by calling 1-844-405-6185 or visiting their website.
It's recommended to avoid breastfeeding while taking Marplan (isocarboxazid). We don't know much about how the medication affects your baby or your milk supply. Ask your care team about options other than breastfeeding like using formula. If you want to breastfeed, ask if there's a different antidepressant that might be safer.
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Risks and warnings for Marplan (isocarboxazid)
Marplan (isocarboxazid) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Suicidal thoughts or behavior
- Risk factors: People 24 years or younger | History of depression or other mood problems
People taking Marplan (isocarboxazid) might notice their depression getting worse. Some might also have changes in behavior or thoughts of suicide or self-harm. The risk is highest for people who are 24 years or younger.
Watch for signs like worse depression, anxiety, anger, and restlessness, especially during the first few weeks of taking Marplan (isocarboxazid) or after a dose change. If you or someone else notices these changes, tell your prescriber. Call 911 right away if you have any thoughts of suicide.
Not for use alone in bipolar disorder
Depression can be the first sign of bipolar disorder. Taking antidepressants like Marplan (isocarboxazid) alone can sometimes cause a manic episode in people at risk for bipolar disorder.
Before you start Marplan (isocarboxazid), your prescriber will check if you have or are at risk of bipolar disorder. Marplan (isocarboxazid) isn't used to treat bipolar depression.
Tell your prescriber right away if you or your loved ones notice any unusual behavior while taking Marplan (isocarboxazid). Watch for signs of mania, like having racing thoughts, being restless, getting easily distracted, or talking a lot.
Dangerously high blood pressure
- Risk factors: History of high blood pressure | Eating fermented or smoked foods | Drinking beer and wine | Taking certain medications that can raise blood pressure
Although it's rare, some people can have dangerously high blood pressure while taking Marplan (isocarboxazid). The risk is higher if you eat foods with a lot of tyramine during treatment. Examples include aged cheese, cured or smoked meats, and pickled or fermented food. Talk to your healthcare team about which foods and drinks to avoid.
Taking certain medications with Marplan (isocarboxazid) can also raise your risk of very high blood pressure. Be sure to tell your healthcare team about all the medications you take. They can help keep you safe by adjusting your treatment, if needed.
Tell your prescriber if you check your blood pressure and it stays higher than usual. Extremely high blood pressure is a medical emergency. Stop taking Marplan (isocarboxazid) and call 911 right away if you have severe headaches, chest pain, fast heartbeat, confusion, or blurry vision. These can be signs of dangerously high blood pressure.
Use with caution in people with seizures
- Risk factors: History of seizures
Talk to your prescriber if you've had seizures before and if you take medications to control them. Though it's rare, Marplan (isocarboxazid) can make seizures more likely. Your prescriber might need to adjust any seizure medications you take to help keep seizures under control.
Possible liver damage
It's rare, but Marplan (isocarboxazid) might hurt your liver. Your prescriber might have you do occasional blood tests to check your liver while you're taking this medication. Stop taking Marplan (isocarboxazid) and tell your prescriber if your skin or eyes turn yellowish. This could be a sign of liver damage.
Serotonin syndrome
- Risk factors: Taking more than one antidepressant | Taking other medications that can affect serotonin
Taking Marplan (isocarboxazid) with other medications that raise your serotonin levels can raise your risk of a rare but serious problem called serotonin syndrome. Tell your healthcare team about all your medications, especially antidepressants and mental health medications. Your care team will check to make sure it's safe to take them together.
Get medical help right away if you have a fast heartbeat, sweating, stiff or twitching muscles, fever, and confusion. These could be signs of serotonin syndrome.
Possible effect on certain other conditions
Tell your healthcare team about all the health conditions you have. MAOIs like Marplan (isocarboxazid) can raise the risk of problems related to certain conditions you have. These include kidney problems, diabetes, hyperthyroidism (overactive thyroid), anxiety, agitation, or schizophrenia.
Marplan (isocarboxazid) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10mg | 120 tablets | $577.33 | $4.81 |
Typical dosage for Marplan (isocarboxazid)
The typical starting dose is 10 mg by mouth twice a day.
Your prescriber will slowly raise your dose based on how well it works for your depression and if you have side effects. Your daily dose is usually split into 2 to 4 smaller doses taken throughout the day.
The maximum dose is 60 mg per day.
Interactions between Marplan (isocarboxazid) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Amitriptyline
- Amoxapine
- Amphetamine
- Apraclonidine
- Atomoxetine
- Benzphetamine
- Brimonidine
- Bupropion
- Buspirone
- Carbamazepine
- Carbidopa
- Carbinoxamine
- Citalopram
- Clomipramine
- Clovoxamine
- Codeine
- Cyclobenzaprine
- Cyproheptadine
- Desipramine
- Desvenlafaxine
- Deutetrabenazine
- Dexfenfluramine
- Dexmethylphenidate
- Dextroamphetamine
- Dextromethorphan
- Diethylpropion
- Dobutamine
- Dopamine
- Dothiepin
- Doxepin
- Doxylamine
- Duloxetine
- Entacapone
- Ephedrine
- Epinephrine
- Escitalopram
- Femoxetine
- Fenfluramine
- Fluoxetine
- Fluvoxamine
- Furazolidone
- Guanadrel
- Guanethidine
- Hydroxytryptophan
- Imipramine
- Isometheptene
- Isoproterenol
- Levodopa
- Levomethadyl
- Levomilnacipran
- Linezolid
- Lisdexamfetamine
- Lofepramine
- Maprotiline
- Mazindol
- Meperidine
- Mephentermine
- Metaraminol
- Methamphetamine
- Methotrimeprazine
- Methoxamine
- Methyldopa
- Methylene Blue
- Methylphenidate
- Milnacipran
- Mirtazapine
- Nefazodone
- Nefopam
- Norepinephrine
- Nortriptyline
- Opicapone
- Opipramol
- Ozanimod
- Pargyline
- Paroxetine
- Phendimetrazine
- Phenelzine
- Phenmetrazine
- Phentermine
- Phenylalanine
- Phenylephrine
- Phenylpropanolamine
- Procarbazine
- Protriptyline
- Pseudoephedrine
- Rasagiline
- Reserpine
- Rizatriptan
- Safinamide
- Selegiline
- Serdexmethylphenidate
- Sertraline
- Sibutramine
- Solriamfetol
- Sumatriptan
- Tapentadol
- Tetrabenazine
- Tramadol
- Tranylcypromine
- Trazodone
- Trimipramine
- Tryptophan
- Venlafaxine
- Vilazodone
- Viloxazine
- Vortioxetine
- Zolmitriptan
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alfentanil
- Almotriptan
- Atropine
- Benzhydrocodone
- Buprenorphine
- Butorphanol
- Difenoxin
- Dihydrocodeine
- Diphenoxylate
- Dolasetron
- Droperidol
- Ethchlorvynol
- Fentanyl
- Frovatriptan
- Granisetron
- Guarana
- Hydrocodone
- Hydromorphone
- Iobenguane I 123
- Kava
- Lasmiditan
- Levorphanol
- Licorice
- Lithium
- Lorcaserin
- Ma Huang
- Mate
- Metaxalone
- Methadone
- Metoclopramide
- Midodrine
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Naratriptan
- Ondansetron
- Oxycodone
- Oxymetazoline
- Oxymorphone
- Palonosetron
- Pentazocine
- Reboxetine
- Remifentanil
- St John's Wort
- Sufentanil
- Tolcapone
- Tyrosine
- Valbenazine
- Ziprasidone
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acarbose
- Chlorpropamide
- Ginseng
- Glimepiride
- Glipizide
- Glyburide
- Insulin
- Insulin Aspart, Recombinant
- Insulin Bovine
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Lispro, Recombinant
- Metformin
- Nateglinide
- Repaglinide
- Tolazamide
- Tolbutamide
How much does Marplan (isocarboxazid) cost?
$577.33
Marplan (isocarboxazid) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Marplan (isocarboxazid) will not be safe for you to take.
- Stroke or "mini" stroke
- Heart disease
- High blood pressure
- Severe kidney problems
- Liver problems
- Pheochromocytoma (a type of adrenal gland tumor)
- Surgery that requires general anesthesia
- Eat foods with high amounts of tyramine
- Drink alcohol while taking
- Drink large amounts of caffeine while taking
- Take with meperidine or certain other opioids
- Take with stimulant medications like phentermine (Adipex-P) or Adderall (amphetamine salt combination)
- Take with medications that have dextromethorphan in them
- Take with medications that raise serotonin levels
- Take with buspirone (Buspar), bupropion or other antidepressants
- Take with blood pressure medications
What are alternatives to Marplan (isocarboxazid)?
