Tranylcypromine Sulfate Oral tablet

What is this medicine?

TRANYLCYPROMINE (tran il SIP roe meen) is an monoamine oxidase inhibitor (MAOI). It is used to treat depression.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• frequently drink alcohol-containing beverages

• glaucoma

• headaches or migraine

• heart disease

• high blood pressure

• history of irregular heartbeat

• history of stroke

• kidney disease

• liver disease

• mental illness

• pheochromocytoma

• recent head trauma

• seizures

• suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member

• an unusual or allergic reaction to tranylcypromine, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking this medicine suddenly except upon the advice of your doctor. Stopping this medicine too quickly may cause serious side effects or your condition may worsen.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• altretamine

• atomoxetine

• brimonidine

• buspirone

• caffeine

• carbamazepine

• certain medicines for blood pressure like guanabenz, guanadrel, guanethidine, or reserpine

• cocaine

• cyclobenzaprine

• dextromethorphan

• diet pills or stimulants, like amphetamines or ephedra

• diphenoxylate

• disulfiram

• doxapram

• ephedrine

• general or local anesthetics

• ginseng

• green tea

• guarana

• isoniazid

• linezolid

• MAOIs like Azilect, Carbex, Eldepryl, Nardil, and Parnate

• medicines for high blood pressure

• medicines for migraine headaches

• medicines for movement abnormalities as in Parkinson's disease like entacapone, levodopa, selegiline, tolcapone

• meperidine

• methylene blue

• other medicines for mental depression, anxiety, or mood or mental problems

• prescription pain medicines

• procarbazine

• SAM-e

• St. John's wort

• succinylcholine

• tramadol

• tyramine (found in cheese, red wine, beer, chocolate and other foods)

• tryptophan

• yohimbine

This medicine may also interact with the following medications:

• medicines for diabetes

• phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Tell your doctor if your symptoms do not get better or if they get worse. Visit your doctor or health care professional for regular checks on your progress. Because it may take several weeks to see the full effects of this medicine, it is important to continue your treatment as prescribed by your doctor.

This medicine can interact with certain foods that contain tyramine. The combination may cause severe headaches, a rise in blood pressure, or irregular heart beat. Foods that contain significant amounts of tyramine include aged cheeses, meats and fish (especially aged, smoked, pickled, or processed such as bologna, pepperoni, salami, summer sausage), beer and ale, alcohol-free beer, wine (especially red), sherry, hard liquor, liqueurs, avocados, bananas, figs, raisins, soy sauce, miso soup, yeast/protein extracts, bean curd, fava or broad bean pods, or any over-ripe fruit. Ask your doctor or health care professional, pharmacist, or nutritionist for a complete listing of tyramine-containing foods. Also, avoid drinks containing caffeine, such as tea, coffee, chocolate, or cola. After stopping this medicine, ask your health care professional how long you should continue avoiding these foods and drinks.

Patients and their families should watch out for new or worsening thoughts of suicide or depression. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care professional.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

This medicine may cause dry eyes and blurred vision. If you wear contact lenses you may feel some discomfort. Lubricating drops may help. See your eye doctor if the problem does not go away or is severe.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

Do not treat yourself for coughs, colds, or allergies without asking your doctor or health care professional for advice. Do not take any medications for weight loss without your doctor's approval. Some ingredients in these products may increase possible side effects.

This medicine may affect blood sugar levels. If you have diabetes, check with your doctor or health care professional before you change your diet or the dose of your diabetic medicine.

Tell your health care professional that you are taking this medicine if you are scheduled to have any surgery, procedure or medical testing. You should usually stop taking this drug at least 10 days before elective surgery.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• agitation, excitability, restlessness, or nervousness

• breathing problems

• chest pain

• confusion, depression, or changes in mental state

• difficulty passing urine

• enlarged pupils

• fast, irregular, slow heartbeat

• feeling faint or lightheaded, falls

• fever, clammy skin, sweating, sore throat

• headache

• high blood pressure

• muscle or neck stiffness or spasm

• seizures

• suicidal thoughts or other mood changes

• yellowing of the skin or eyes

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• change in sex drive or performance

• constipation or diarrhea

• increased appetite or weight increase

• increased sensitivity to sunlight

• muscle aches or pains, trembling

• nausea or vomiting

• swelling of the feet or legs

• weak or tired

• trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Keep container tightly closed. Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.