Indications for NARDIL:
Initially 15mg three times daily. Increase if needed to max 90mg daily. Reduce dose as condition improves.
<16 yrs: not recommended.
See Interactions. Pheochromocytoma. Cardiovascular, cerebrovascular, or liver disease. Hypertension. Chronic headache. To avoid potentially severe or fatal interactions, allow sufficient drug-free interval (see full labeling) between phenelzine and: sympathomimetics (eg, amphetamines, pseudoephedrine), tricyclic antidepressants (eg, amitriptyline), maprotiline, mirtazapine, SSRIs or other neurotransmitter reuptake inhibitors (eg, fluoxetine), CNS depressants (eg, alcohol, barbiturates, narcotics), antihistamines, antihypertensives (eg, guanethidine), anesthetics, bupropion, buspirone, carbamazepine, cyclobenzaprine, dibenzazepines, diuretics, dextromethorphan, dopamine, other MAOIs (eg, tranylcypromine, selegiline, furazolidone, isocarboxazid), levodopa, methyldopa, methylphenidate, tryptophan, phenylalanine, tryptophan-, dopamine-, tyrosine-, or tyramine-containing foods, excess caffeine or chocolate. Meperidine within three weeks of phenelzine.
Suicidality and antidepressant drugs.
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor all patients for clinical worsening or unusual behavioral changes. Screen for risk of bipolar disorder prior to initiation. Mania/hypomania. Psychosis. Epilepsy. Hyperthyroidism. Surgery. Discontinue if palpitations or headache occurs and 48 hrs before to 24 hrs after myelography. Avoid abrupt cessation. Hypotension. Monitor blood pressure and observe patient frequently. May mask anginal pain or aggravate anxiety or agitation. Elderly. Debilitated. Pregnancy. Nursing mothers.
See Contraindications. Hypertensive crises with sympathomimetics, levodopa, and high-tyramine foods (including cheese, salami, chocolate, wine, beer, pickled herring, chicken livers, yeast extract, yogurt, broad beans, others). Caution with antidiabetic agents, antiparkinson agents, disulfiram. Potentiates CNS depressants, antihypertensives. Psychosis with dextromethorphan. Circulatory collapse, coma, death with meperidine. Do not start within 5 wks of fluoxetine, or 2 wks of sertraline, paroxetine, bupropion, citalopram, or 1 wk of venlafaxine discontinuance.
Orthostatic hypotension, headache, CNS overstimulation, jaundice, seizures, changes in blood sugar, anticholinergic effects, GI disorders, rash, weight gain, sexual disturbances.