Phenelzine

FDA label

Read the full label on DailyMed ↗

Renal Contraindicated in severe renal impairment/disease

Hepatic Contraindicated in liver disease or abnormal LFTs

Maintenance dose may be as low as 15 mg daily or every other day.

Instructions

• Taper slowly over several weeks after maximum benefit
• Avoid high-tyramine foods (aged cheese, cured/fermented meats, tap beer, wine, fava beans, yeast extract)
• Allow >=14 days washout before/after other MAOIs or serotonergic agents; discontinue >=10 days before elective surgery

Contraindications

• Pheochromocytoma
• Congestive heart failure
• Severe renal impairment or renal disease
• History of liver disease or abnormal liver function tests
• Sympathomimetics (amphetamines, cocaine, methylphenidate, dopamine, epinephrine, norepinephrine) and related compounds (methyldopa, L-dopa, L-tryptophan, L-tyrosine, phenylalanine)
• High-tyramine foods (risk of hypertensive crisis)
• Other MAO inhibitors; buspirone
• Meperidine
• Dextromethorphan; CNS depressants (alcohol, narcotics)
• Serotonergic agents (SSRIs/SNRIs) — risk of serotonin syndrome
• Bupropion
• Guanethidine
• Elective surgery requiring general anesthesia; cocaine or local anesthetics with sympathomimetic vasoconstrictors

Cautions

• Hypertensive crisis with tyramine foods or sympathomimetics
• Serotonin syndrome with serotonergic drugs
• Suicidality in young patients (boxed)
• Postural hypotension

Adverse reactions

• Dizziness, headache, drowsiness, sleep disturbance
• Postural hypotension, edema
• Weight gain, dry mouth, constipation
• Sexual dysfunction (anorgasmia, ejaculatory disturbance, impotence)
• Elevated serum transaminases

Pregnancy Undefined

Lactation Undefined