Isocarboxazid tablets

What are isocarboxazid tablets?

ISOCARBOXAZID (Marplan®) belongs to a class of drugs called monoamine oxidase inhibitors (MAOIs). Isocarboxazid increases the level of certain chemicals in the brain that help fight depression and other mood problems, including certain anxiety disorders. Isocarboxazid can interact with certain foods and other medicines to cause unpleasant side effects. You must know what foods and medicines to avoid (see below). Generic isocarboxazid tablets are not yet available.

What should my health care professional know before I take isocarboxazid?

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

• frequently drink alcohol-containing beverages

• asthma or bronchitis

• attempted suicide

• bipolar disorder or mania

• diabetes

• headaches or migraine

• heart or blood vessel disease, or irregular heart beats

• high blood pressure

• kidney disease

• liver disease

• over-active thyroid

• Parkinson's disease

• pheochromocytoma

• recent head trauma

• seizures or convulsions

• schizophrenia or psychosis

• stroke or other cerebrovascular disease

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

• pregnant or trying to get pregnant

• breast-feeding

How should I take this medicine?

Take isocarboxazid tablets by mouth. Follow the directions on the prescription label. Swallow the tablets with a drink of water. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking the tablets except on your prescriber's advice.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

Elderly patients over age 65 years may have a stronger reaction to this medicine and should use this medicine with caution.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is less than two hours to your next dose, take only that dose and skip the missed dose. Do not take double or extra doses.

What drug(s) may interact with isocarboxazid?

• alcohol

• barbiturates such as phenobarbital

• bupropion

• buspirone

• caffeine

• carbamazepine

• certain medicines for blood pressure (especially beta-blockers, methyldopa, reserpine, guanadrel, and guanethidine)

• cocaine

• dextromethorphan

• diet pills or stimulants, like amphetamines or ephedra

• furazolidone

• ginseng

• guarana

• kava kava

• levodopa

• linezolid

• local anesthetics

• medicines for allergies, colds, flu symptoms, sinus congestion, and breathing difficulties

• medicines for diabetes

• medicines for migraine headaches

• medicines for movement abnormalities as in Parkinson's disease (examples: entacapone, levodopa, selegiline, tolcapone)

• muscle relaxants

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

• meperidine

• procarbazine

• SAM-e

• seizure (convulsion) or epilepsy medicine

• St. John's wort

• tramadol

• tryptophan

• tyramine—see below for foods that contain tyramine

• valerian

• water pills (diuretics)

• yohimbine

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking isocarboxazid?

Visit your prescriber or health care professional for regular checks on your progress. It can take up to 3—6 weeks to see the full effects of isocarboxazid. Do not suddenly stop taking your medicine; this may make your condition worse or give you withdrawal symptoms. Ask your prescriber or health care professional for advice about gradually reducing your dosage. Even after you stop taking isocarboxazid the effects can last for at least two weeks. Continue to take all precautions and avoid all food and medicine that interact with isocarboxazid.

Isocarboxazid can interact with certain foods that contain tyramine to produce 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 prescriber 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.

Call your prescriber or health care professional as soon as you can if you get frequent headaches or have palpitations.

You may get drowsy, dizzy or have blurred vision. Do not drive, use machinery, or do anything that needs mental alertness until you know how isocarboxazid 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 increase dizziness or drowsiness; avoid alcoholic drinks.

Isocarboxazid can make your mouth dry. Chewing sugarless gum, sucking hard candy and drinking plenty of water will help.

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

If you are diabetic there is a possibility that isocarboxazid may affect your blood sugar. Ask your prescriber or health care professional for advice if there is any change in your blood or urine sugar tests.

Notify your health care professional if you are scheduled to have any surgery, procedure or medical testing (including myelography).You should usually stop taking this drug at least 10 days before elective surgery; tell your prescriber or health care professional that you have been taking isocarboxazid.

What side effects may I notice from taking isocarboxazid?

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

• agitation, excitability, restlessness, or nervousness

• chest pain

• confusion or changes in mental state

• convulsions or seizures (uncommon)

• difficulty breathing

• difficulty passing urine

• enlarged pupils, sensitivity of the eyes to light

• fever, clammy skin, increased sweating

• headache or increased blood pressure

• lightheadedness or fainting spells

• muscle or neck stiffness or spasm

• sexual dysfunction

• slow, fast, or irregular heartbeat (palpitations)

• sore throat and fever

• yellowing of the skin or eyes

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

• blurred vision or change in vision

• constipation or diarrhea

• difficulty sleeping

• drowsiness or dizziness

• dry mouth

• increased appetite; weight increase

• increased sensitivity to sunlight

• muscle aches or pains, trembling

• nausea or vomiting

• sexual dysfunction

• swelling of the feet or legs

• tiredness or weakness

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

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.