tranylcypromine
Tranylcypromine (Parnate) is taken by mouth and used to treat depression. It's not a first choice medication because it has many drug and food interactions. It can also put you at risk for dangerously high blood pressure. Tranylcypromine (Parnate) is usually used after other medications haven't worked well. It's available as a lower-cost generic.
What is Tranylcypromine (Parnate)?
What is Tranylcypromine (Parnate) used for?
- Depression when other medications haven't worked
How Tranylcypromine (Parnate) works
Tranylcypromine (Parnate) is a monoamine oxidase inhibitor (MAOI). It blocks a protein in your brain that breaks down certain chemicals, such as norepinephrine, dopamine, and serotonin. This allows these chemicals to stay in your brain longer, which can help improve your mood.
Drug facts
Side effects of Tranylcypromine (Parnate)
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
- Dry mouth
- Dizziness
- Trouble sleeping
- Sleepiness
- Headache
- Overexcitement
- Constipation
- Blurry vision
- Tremor, shakiness
Less Common Side Effects
- Loss of appetite, anorexia
- Weight gain
- Anxiety
- Sexual dysfunction
- Ringing in the ear
- Fast heartbeat
- Bladder problems
- Fluid retention, bloating
- Double vision
- Poor coordination
Tranylcypromine (Parnate) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts or behavior
- Serotonin syndrome: fast heart rate, sweating, muscle stiffness or spasms, fever, confusion
- Dangerously high blood pressure: severe headache, changes in your heart rate, neck stiffness or soreness, nausea, vomiting
- Liver damage: fever, rash, tiredness, nausea, vomiting, loss of appetite, yellowing of your eyes and skin
- Low blood sugar: hunger, anxiety, trembling, shaking, sweating, feeling faint, feeling irritated
- Seizures
The following Tranylcypromine (Parnate) 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:
Incidence not known
Absence of or decrease in body movement
actions that are out of control
agitation
black, tarry stools
bleeding gums
blood in the urine or stools
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
chills
confusion
confusion about identity, place, and time
dark urine
decrease in frequency of urination
decrease in urine volume
decreased awareness or responsiveness
difficulty in passing urine (dribbling)
dizziness
fast, irregular, pounding, or racing heartbeat or pulse
fever with or without chills
general feeling of tiredness or weakness
headache
hoarseness
hostility
hyperventilation
increased need to urinate
irritability
light-colored stools
longer than usual time to ejaculation of semen
loss of bladder control
loss of consciousness
lower back or side pain
muscle twitching
nervousness
painful or difficult urination
pale skin
passing urine more often
pinpoint red spots on the skin
rapid weight gain
restlessness
seizures
severe sleepiness
shakiness and unsteady walk
sores, ulcers, or white spots on the lips or in the mouth
sudden jerky movements of the body
swelling of the face, ankles, or hands
swollen glands
talking, feeling, and acting with excitement
trouble with sleeping
troubled breathing with exertion
unsteadiness, trembling, or other problems with muscle control or coordination
unusual bleeding or bruising
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
upper right abdominal pain
vomiting
yellow eyes and skin
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:
Incidence not known
Blurred vision
continuing ringing or buzzing or other unexplained noise in the ears
decreased interest in sexual intercourse
drowsiness
hair loss or thinning of the hair
hearing loss
hives or welts, itching, skin rash
inability to have or keep an erection
loss in sexual ability, desire, drive, or performance
loss of appetite
memory loss
redness of the skin
stomach pain
unable to sleep
weakness
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 Tranylcypromine (Parnate)
Pros
- Possible option if first-choice medications for depression haven't worked
- Available as a lower-cost generic
Cons
- Needs to be taken multiple times a day
- Many food and medication interactions
Pharmacist tips for Tranylcypromine (Parnate)
- Tranylcypromine (Parnate) should be taken in divided doses, typically twice a day. Work closely with your provider to find the right dose and dosing schedule that works for you.
- There are a lot of medications that tranylcypromine (Parnate) can interact with. Let your provider know that you're taking tranylcypromine (Parnate), especially if they want you to start a new antidepressant. Sometimes you have to wait at least 2 weeks after stopping tranylcypromine (Parnate) to safely start the new one.
- Tranylcypromine (Parnate) can make you feel very drowsy or sleepy, especially when you first start this medication or when there's a change in your dose. You should avoid any activities that require you to be alert, like driving a car or operating heavy machinery, until you know how this medication makes you feel.
- Tranylcypromine (Parnate) can cause changes to your blood pressure and blood sugar. You might have to monitor these two things more often, especially if you have high blood pressure or diabetes, so ask your provider how often you need to do so.
- If you need to get surgery, you should stop tranylcypromine (Parnate) at least 10 days before your surgery. If not, you can experience potentially dangerous blood pressure problems if you're using anesthesia during surgery. Talk to your provider about how to stop this medication safely.
- Don't suddenly stop taking tranylcypromine (Parnate) because it can lead to withdrawals symptoms, such as nausea, vomiting, and extreme tiredness. If you want to stop this medication, ask your provider how to lower your dose slowly over time.
- You might continue to feel the effects of tranylcypromine (Parnate) for up to 10 days after you stop this medication. During this time, continue to avoid food or medications that might interact with this medication.
Common questions about Tranylcypromine (Parnate)
It can take 2 to 4 weeks before you feel the effects of tranylcypromine (Parnate). Let your provider know if you've been taking the medication for more than a month and don't notice a change in your depression symptoms. If this happens, your dose might need to be adjusted or your medication might need to be switched.
Limit foods that have been fermented, aged, pickled, or smoked. Examples include: cheese, yogurt, dry sausage (salami, pepperoni, bologna), fava beans, pickled herring, liver, and sauerkraut. These foods have high tyramine levels and can raise your risk for dangerously high blood pressure if you eat them while taking tranylcypromine (Parnate). Read this article for more information on what foods to avoid while taking this medication.
Don't drink alcoholic beverages while taking tranylcypromine (Parnate). The combination can make you very drowsy and dizzy, which can put you at risk for falls. Also, drinks, such as beer and wine, are fermented. Drinking them and taking this medication at the same time can lead to dangerously high blood pressure. Even alcohol-free beer and wine should be avoided.
Always check with a pharmacist or provider before starting any new medication while taking tranylcypromine (Parnate). Common over-the-counter (OTC) medications to avoid with tranylcypromine (Parnate) include common cough and cold medications, such as dextromethorphan (Delsym), diphenhydramine (Benadryl) (Benadryl), and pseudoephedrine (Sudafed). Doing so can lead to dangerous side effects, like serotonin syndrome, very high blood pressure, or extreme drowsiness. Many of the mentioned OTC medications are sold in combination products and available in a variety of brand names, so always check the label for active ingredients.
MAOIs aren't used often because they have many side effects, diet restrictions, and drug interactions. Many people cannot tolerate the side effects and must watch their diet because certain foods can interact with the medications and cause serious side effects, such as dangerously high blood pressure. Tranylcypromine (Parnate) is typically used when first-choice medications for depression didn't work well for you. Your healthcare provider will discuss the risks and benefits of this medication with you so that you can make an informed decision.
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Risks and warnings for Tranylcypromine (Parnate)
Tranylcypromine (Parnate) 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 | Taking antidepressants | Starting tranylcypromine (Parnate) for the first time | Change in dose of tranylcypromine (Parnate)
Tranylcypromine (Parnate) can raise the risk of suicidal thoughts or behavior. Watch for new or worsening depression, suicidal thoughts or behavior, especially during the first few months of treatment or when the dose changes. Let your healthcare provider know right away if you notice any unusual changes in mood or behavior while taking this medication.
Dangerously high blood pressure
- Risk factors: History of high blood pressure | Eating fermented or smoked foods | Drinking beer or wine | Taking certain medications
MAOI medications like tranylcypromine (Parnate) can cause your blood pressure to become too high, which in some cases can be fatal. Certain foods like processed meat (salami, pepperoni), cheese, yogurt, or any food or drink that has been aged, pickled, or fermented can raise the risk of high blood pressure and should be avoided. There are also medications, like over-the-counter (OTC) cough and cold medications, weight loss supplements, and allergy medications that should also be avoided while taking tranylcypromine (Parnate). Always talk to a provider or pharmacist before starting any new medications to make sure it doesn't interact with your current medications. Seek medical help if you ever have signs of high blood pressure, such as a very bad headache, a pounding heart, neck stiffness or soreness, or nausea and vomiting.
Serotonin syndrome
- Risk factors: Taking tranylcypromine (Parnate) with other medications that raise serotonin levels
Serotonin syndrome is a rare, but potentially life-threatening, condition that happens when there's too much serotonin active in the brain. This is more likely to happen if you're also taking other medications that affect serotonin levels, such as other antidepressants, lithium (Lithobid), triptans, and St. John's Wort. Symptoms of serotonin syndrome include fast heartbeat, sweating, muscle stiffness or spasms, fever, and confusion. Go to the emergency room right away if you think you are having these symptoms.
Possible bipolar disorder
Sometimes depression can be the first sign of bipolar disorder. Unfortunately, tranylcypromine (Parnate) doesn't treat bipolar and can cause a manic phase. Your provider will screen you for bipolar disorder before starting tranylcypromine (Parnate). Let them know your full medical history and if anyone in your family has a history of bipolar disorder.
Low blood pressure
- Risk factors: Older adults | Blood pressure problems | Taking other medications that lower blood pressure | Taking tranylcypromine (Parnate) above 30 mg daily
Tranylcypromine (Parnate) can cause a sudden drop in blood pressure. Dizziness and falls can happen due to a sudden drop in blood pressure when you change positions, such as going from sitting to standing. If you're sensitive to low blood pressure, change positions slowly until your body is used to the medication. If your blood pressure suddenly drops, you can try lying down to see if that helps. This problem typically goes away after you stop tranylcypromine (Parnate).
Withdrawal
- Risk factors: Taking tranylcypromine (Parnate) for a long time | Stopping tranylcypromine (Parnate) too quickly
Don't stop taking medications for depression without first talking to your provider. Stopping tranylcypromine (Parnate) suddenly can lead to unwanted effects such as headache, dizziness, nausea, trouble sleeping, feeling irritable, diarrhea, anxiety, tiredness, abnormal dreams, and more sweating. If you and your provider agree to stop this medication, they can develop a plan to lower the dose slowly, which can help avoid these symptoms.
Low blood sugar in people with diabetes
- Risk factors: Taking blood sugar lowering medications | Diabetes
Sometimes, MAOIs like tranylcypromine (Parnate) can worsen low blood sugar in people with diabetes. Make sure you monitor your blood sugar closely, especially if you're taking blood sugar lowering medications like insulin. If your sugars continue to stay low, talk to the provider who prescribed your diabetes medications. They might want to adjust the doses. Get medical help right away if you experience symptoms of low blood sugar, such as hunger, anxiety, trembling, shaking, and sweating.
Liver damage
- Risk factors: History of liver problems
Tranylcypromine (Parnate) can cause damage to your liver. If you already have livery problems, this medication might cause you to feel more sleepy. Talk to your provider right away if you have symptoms of liver damage, such as tiredness, nausea, vomiting, loss of appetite, and yellowing of your eyes and skin.
Tranylcypromine (Parnate) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10mg | 180 tablets | $82.83 | $0.46 |
Typical dosage for Tranylcypromine (Parnate)
The typical dosing is 30 mg by mouth daily, in divided doses. The maximum dose is 30 mg twice daily.
Interactions between Tranylcypromine (Parnate) 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.
- Acrivastine
- Almotriptan
- Amezinium
- Amineptine
- Amitriptyline
- Amitriptylinoxide
- Amoxapine
- Amphetamine
- Antazoline
- Apraclonidine
- Atomoxetine
- Azatadine
- Benzphetamine
- Brimonidine
- Bromodiphenhydramine
- Brompheniramine
- Buclizine
- Bupropion
- Buspirone
- Carbamazepine
- Carbidopa
- Carbinoxamine
- Chlorpheniramine
- Chlorphenoxamine
- Cinnarizine
- Citalopram
- Clemastine
- Clomipramine
- Clovoxamine
- Codeine
- Cyclizine
- Cyclobenzaprine
- Cyproheptadine
- Desipramine
- Desvenlafaxine
- Deutetrabenazine
- Dexbrompheniramine
- Dexchlorpheniramine
- Dexfenfluramine
- Dexmethylphenidate
- Dextroamphetamine
- Dextromethorphan
- Dibenzepin
- Diethylpropion
- Dimenhydrinate
- Dimethindene
- Diphenhydramine
- Dobutamine
- Dopamine
- Dopexamine
- Dothiepin
- Doxepin
- Doxylamine
- Droxidopa
- Duloxetine
- Eletriptan
- Entacapone
- Ephedrine
- Epinephrine
- Escitalopram
- Etilefrine
- Femoxetine
- Fenfluramine
- Flunarizine
- Fluoxetine
- Fluvoxamine
- Frovatriptan
- Furazolidone
- Guanadrel
- Guanethidine
- Hydroxytryptophan
- Hydroxyzine
- Imipramine
- Iproniazid
- Isocarboxazid
- Isoetharine
- Isometheptene
- Levodopa
- Levomethadyl
- Levomilnacipran
- Linezolid
- Lisdexamfetamine
- Lofepramine
- Maprotiline
- Mazindol
- Meclizine
- Melitracen
- Meperidine
- Mephentermine
- Metaraminol
- Methamphetamine
- Methdilazine
- Methotrimeprazine
- Methoxamine
- Methyldopa
- Methylene Blue
- Methylphenidate
- Midodrine
- Milnacipran
- Mirtazapine
- Moclobemide
- Naratriptan
- Nefazodone
- Nefopam
- Nialamide
- Norepinephrine
- Nortriptyline
- Opicapone
- Opipramol
- Oxatomide
- Oxilofrine
- Ozanimod
- Pargyline
- Paroxetine
- Phendimetrazine
- Phenelzine
- Pheniramine
- Phenmetrazine
- Phentermine
- Phenylalanine
- Phenylephrine
- Phenylpropanolamine
- Phenyltoloxamine
- Procarbazine
- Promethazine
- Propylhexedrine
- Protriptyline
- Pseudoephedrine
- Pyrilamine
- Rasagiline
- Reserpine
- Rizatriptan
- S-Adenosylmethionine
- Safinamide
- Selegiline
- Serdexmethylphenidate
- Sertraline
- Sibutramine
- Solriamfetol
- Sumatriptan
- Tapentadol
- Terbutaline
- Tetrabenazine
- Tianeptine
- Tramadol
- Trazodone
- Trimipramine
- Tripelennamine
- Triprolidine
- 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
- Atropine
- Benzhydrocodone
- Buprenorphine
- Butorphanol
- Difenoxin
- Dihydrocodeine
- Diphenoxylate
- Disulfiram
- Dolasetron
- Droperidol
- Ethchlorvynol
- Fentanyl
- Granisetron
- Guarana
- Hydrocodone
- Hydromorphone
- Iobenguane I 123
- Iobenguane I 131
- Kava
- Lasmiditan
- Levorphanol
- Licorice
- Lithium
- Lorcaserin
- Ma Huang
- Mate
- Metaxalone
- Methadone
- Metoclopramide
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Ondansetron
- Oxcarbazepine
- Oxycodone
- Oxymetazoline
- Oxymorphone
- Palonosetron
- Pentazocine
- Reboxetine
- Remifentanil
- St John's Wort
- Sufentanil
- Tegafur
- 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 Tranylcypromine (Parnate) cost?
Tranylcypromine (Parnate) 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 Tranylcypromine (Parnate) will not be safe for you to take.
- Tranylcypromine (Parnate) can't be taken at the same as many medications. The list includes: antidepressants (SSRIs, SNRIs, TCAs, bupropion, trazodone), migraine medications, allergy medications, weight loss products, and OTC cough and cold medications
- Tumor on an adrenal gland (pheochromocytoma)
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