Classes
DEA Class; Rx
Common Brand Names; Nardil
- Antidepressants, MAO Inhibitors
Description
Non-selective monoamine oxidase A and B inhibitor (MAOI) antidepressant
FDA-approved for the treatment of major depressive disorder (MDD); used off-label as a second- or third-line agent for anxiety disorders such as panic disorder and social anxiety disorder
Primarily used for treatment-resistant cases of depression and anxiety disorders, due to dietary restrictions, adverse effect profile, and the potential for serious drug-drug interactions and drug-food interactions
Indications
Indicated for use in treatment-resistant depression, including atypical depression.
Contraindications
Hypersensitivity
Pheochromocytoma, congestive heart failure
Within 10 days of elective surgery using general anesthesia or spinal anesthesia
Liver disease, abnormal liver function tests, or history of hepatic disease
Renal disease, severe renal impairment, ESRD
Adverse Effects
Common
Orthostatic hypotension
Asthenia
Dizziness
Headache
Drowsiness
Fatigue
Hyperreflexia
Sleep disturbance
Somnolence
Weakness
Tremor
Constipation
Dry mouth
Weight gain
Less Common
Confusion
Decreased memory
Paresthesia
Anorexia
Nausea
Vomiting
Impotence
Increased LFT’s
Nystagmus
Urinary frequency or retention
Uncommon
Edema
Anxiety
Irritation
Hypomania
Hypermetabolic syndrome (hyperpyrexia, tachycardia, tachypnea, increased CPK, acidosis)
Arthralgia
SIADH
Rare
Hypertensive crisis
Ataxia
Seizure
Worsening depression
Suicide
Edema of glottis
Leukopenia
Hepatic necrosis, jaundice
Drug-induced lupus erythematosus
Visual disturbance
Warnings
Orthostatic hypotension may occur
Hypertensive reactions may occur from consumption of foods high in tyramine or supplements containing caffeine, tyrosine, tryptophan, phenylalanine, or phenylalanine
Not first-line therapy
Discontinue 10 days before surgery
Therapy not approved for treating any indications in the pediatric population
Most serious reactions involve changes in blood pressure
Therapy may cause excessive stimulation in schizophrenic patients
Drug potentiates hexobarbital hypnosis in animals; barbiturates should be given at a reduced dose with phenelzine
Drug should be used with caution in diabetes mellitus; increased insulin sensitivity may occur; requirements for insulin or oral hypoglycemics may be decreased; there is conflicting evidence as to whether or not MAO inhibitors affect glucose metabolism or potentiate hypoglycemic agents; this should be kept in mind if drug is administered to diabetics
Pregnancy and Lactation
Pregnancy Category: C
Lactation: unknown; use caution
Maximum Dosage
90 mg/day PO.
90 mg/day PO.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Phenelzine sulfate
tablet
- 15mg