Isocarboxazid

FDA label

Read the full label on DailyMed ↗

Titration Increase by 10 mg every 2-4 days through week 1, then by up to 20 mg/week

Renal Contraindicated in severe renal impairment

Hepatic Contraindicated in liver disease or abnormal liver function tests

Instructions

• Divide the daily dose into 2-4 doses
• After maximum response, taper slowly over several weeks
• Allow ≥1 week washout when switching to/from another MAOI or dibenzazepine, then start at half the usual dose
• Discontinue ≥10 days before elective surgery requiring general anesthesia
• Avoid high-tyramine foods (aged cheese, cured/fermented foods, Chianti, etc.) and excess caffeine

Contraindications

• Other MAO inhibitors or dibenzazepine-related tricyclics
• SSRIs and other serotonergic drugs (fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram, venlafaxine)
• Meperidine
• Dextromethorphan
• Sympathomimetics, incl. amphetamines and OTC cold/decongestant/weight-loss products
• Bupropion
• Buspirone
• CNS depressants (narcotics, barbiturates, alcohol)
• Antihypertensives, incl. thiazide diuretics
• High-tyramine foods; excess caffeine
• Confirmed/suspected cerebrovascular defect, cardiovascular disease, hypertension, or history of headache
• Pheochromocytoma
• General/spinal anesthesia; cocaine or local anesthetics with sympathomimetic vasoconstrictors

Cautions

• Suicidality in children/adolescents/young adults
• Hypertensive crisis with high-tyramine foods or sympathomimetics
• Serotonin syndrome with serotonergic drugs, meperidine, or dextromethorphan
• Orthostatic hypotension/syncope
• Caution above 40 mg/day (limited monitored experience)

Adverse reactions

• Dizziness
• Headache
• Dry mouth
• Nausea
• Constipation
• Orthostatic hypotension
• Drowsiness/sedation
• Insomnia, sleep disturbance
• Tremor, myoclonic jerks

Pregnancy Reproductive toxicity not adequately evaluated; use only if clearly needed. Antidepressant pregnancy registry available.

Lactation Undefined