Parnate (Tranylcypromine)

Usual dose:

• It is important that you take PARNATE exactly as your doctor has instructed. The usual starting dose of PARNATE is one 10 mg tablet taken twice a day.
• PARNATE tablets are usually taken in the morning and again mid-afternoon. It is better if you take your tablets at the same times each day.
• You should continue to take your medicine even if you do not feel better, as it may take a number of weeks for your medicine to work.
• Keep taking your tablets, as instructed, until the doctor tells you to stop.
• Talk to your doctor before you stop taking your medication on your own.

Remember: This medicine has been prescribed only for you. Do not give it to anybody else, as they may experience undesirable effects, which may be serious.

Overdose:

If you have taken a large number of tablets all at once, go to the nearest hospital emergency department immediately, even though you may not feel sick. Show the doctor your pack of tablets.

Missed dose:

If you forget to take a PARNATE tablet, do not try to make up for the dose that you missed by taking more than one dose at a time. Wait until the next dose and take your normal dose then.

Like all medications, PARNATE can cause some side effects. You may not experience any of them. For most patients these side effects are likely to be minor and temporary. However, some may be serious. Consult your doctor if you experience these or other side effects, as the dose may have to be adjusted.

If you experience an allergic reaction (including skin rash, hives, swelling, trouble breathing) or any severe or unusual side effects, stop taking the drug and go to the nearest hospital emergency department immediately.

The most common side effects of PARNATE are:

• sleep disturbances (insomnia)
• nausea
• dry mouth
• drowsiness
• weakness
• dizziness
• loss of appetite
• diarrhea
• constipation

PARNATE does not usually affect people's normal activities. However, some people feel drowsiness, dizziness or light headedness while taking it, in which case they should not drive or operate machinery.

Tell your doctor immediately if you notice any of the following:

• severe dizziness or fainting on standing
• fast heartbeat
• blurred vision
• sweating
• edema
• unusual bleeding or bruising
• agitation, confusion or nervousness
• muscle spasms or twitches
• difficulty passing urine
• unusual hair loss or thinning

Stop taking PARNATE and contact your doctor or go to the emergency department of your nearest hospital if the following happens:

• severe or frequent headaches, chest pain, fast or slow heartbeat, neck stiffness or soreness, sweating with initial paleness followed by flushing of the skin, enlarged pupils, nausea and vomiting.

Other rare side effects that have been reported include disorders of the liver and blood.

New or Worsened Emotional or Behavioral Problems:

Particularly in the first few weeks or when doses are adjusted, a small number of patients taking drugs of this type may feel worse instead of better; for example, they may experience unusual feelings of agitation, hostility or anxiety, or have impulsive or disturbing thoughts such as thoughts of self-harm or harm to others. Should this happen to you, or to those in your care if you are a caregiver or guardian, consult your doctor immediately. Close observation by a doctor is necessary in this situation. Do not discontinue your medication on your own. See also Warnings and Precautions:.

Drug Dependence and Discontinuation Symptoms:

It is possible to become dependent on PARNATE. You may experience unwanted effects when you stop taking PARNATE. Withdrawal symptoms such as sleep disturbances, depression, confusion, agitation, hallucinations and other symptoms have been reported after stopping treatment of PARNATE. Tell your doctor as soon as possible if you have these or any other symptoms. Contact your doctor before stopping or reducing your dosage of PARNATE.

Serious Warnings and Precautions

• New or Worsened Emotional or Behavioral Problems: Particularly in the first few weeks or when doses are adjusted, a small number of patients taking drugs of this type may feel worse instead of better; for example, they may experience unusual feelings of agitation, hostility or anxiety, or have impulsive or disturbing thoughts such as thoughts of self-harm or harm to others. Should this happen to you, or to those in your care if you are a caregiver or guardian, consult your doctor immediately. Close observation by a doctor is necessary in this situation. Do not discontinue your medication on your own.
• Hypertensive Crisis: Certain foods and drinks must be avoided during treatment with PARNATE and for two weeks after stopping treatment. This hypertensive reaction can be life-threatening, depending on the amount of tyramine that has been taken (see Interactions with This Medication:).

BEFORE you use PARNATE, tell your doctor or pharmacist:

• all your medical conditions, including a history of stroke, liver disease, blood disorders, kidney disease, heart problems, diabetes, epilepsy, or overactive thyroid gland
• if you have or have ever had recurrent or frequent headaches
• any medications (prescription or non prescription) which you are taking or have recently taken, especially any other antidepressants
• if you are pregnant, plan to become pregnant, or are breastfeeding
• if you are beyond the age of sixty
• your habits of alcohol and/or street drug consumption
• if you had any type of surgery or are planning to have surgery

Effects on Pregnancy and Newborns:

As stated above, ask your doctor or pharmacist for advice before taking any medicine including PARNATE. If you are already taking/using PARNATE and have just found out that you are pregnant, you should talk to your doctor immediately. You should also talk to your doctor if you are planning to become pregnant.

Children and adolescents (less than 18 years of age):

Treatment with antidepressants is associated with an increased risk of suicidal thinking and behaviour in children and adolescents with depression.

Angle-Closure Glaucoma:

PARNATE may cause an acute attack of glaucoma. Having your eyes examined before you take this drug could help identify if you are at risk of having angle-closure glaucoma. Seek immediate medical attention if you experience:

• eye pain
• changes in vision
• swelling or redness in or around the eye.