It is very important that your doctor check your progress at regular visits to allow for changes in your dose and to check for any unwanted effects.
You will also need to have your blood pressure measured before starting treatment with this medicine and while you are using it. If you notice any change to your recommended blood pressure, call your doctor right away. If you have questions about this, talk to your doctor.
Do not use this medicine if you have used another MAO inhibitor within the past 14 days. Do not take an MAO inhibitor for at least 7 days after you stop this medicine.
Do not use this medicine if you are taking buspirone (Buspar®), carbamazepine (Tegretol®), cyclobenzaprine (Flexeril®), methyldopa (Aldomet®), milnacipran (Savella®), rasagiline (Azilect®), reserpine (Serpasil®), tapentadol (Nucynta®, Palexia®, Tapal®), or tetrabenazine (Nitoman®, Xenazine®).
When taken with certain foods, drinks, or other medicines, tranylcypromine can cause very dangerous reactions, such as sudden high blood pressure (also called hypertensive crisis). To avoid such reactions, follow these rules of caution:
Do not eat foods that have a high tyramine content (most common in foods that are aged or fermented to increase their flavor), such as cheese (especially strong or aged kinds), caviar, sour cream, liver, canned figs, soy sauce, sauerkraut, fava beans, yeasts, and yogurt. Avoid smoked or pickled meat, poultry, or fish, such as sausage, pepperoni, salami, anchovies, or herring. Do not eat dried fruit (such as raisins), bananas, avocados, raspberries, or very ripe fruit.
Do not drink alcoholic beverages. This includes Chianti wine, sherry, beer, non-alcohol or low alcohol beer and wine, and liqueurs.
Do not eat or drink too much caffeine. Caffeine can be found in coffee, cola, chocolate, tea, and many other foods and drinks. Ask your doctor how much caffeine is safe to use.
Tranylcypromine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these adverse effects, tell your doctor right away.
Call your doctor or hospital emergency room right away if you have a severe headache, stiff or sore neck, chest pains, fast heartbeat, sweating, dizziness, or nausea and vomiting while you are taking this medicine. These may be symptoms of a serious side effect called hypertensive crisis.
Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.
This medicine may cause blurred vision, drowsiness, or make some people less alert than they are normally. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.
This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.
Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. When you get up from lying down, sit on the edge of the bed with your feet dangling for 1 or 2 minutes, then stand up slowly. If the problem continues or gets worse, check with your doctor.
Do not stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely.
Before having any kind of surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are using this medicine or have used it within the past 10 days. Taking tranylcypromine together with medicines that are used during surgery, dental, or emergency treatments may increase the risk of serious side effects.
Your doctor may want you to carry an identification card stating that you are using this medicine.
This medicine may affect blood sugar levels. If you are diabetic, be especially careful in testing for sugar in your blood or urine. If you have any questions about this, check with your doctor.
After you stop using this medicine, you must continue to exercise caution for at least 2 weeks with your foods, drinks, and other medicines, since these items may continue to react with tranylcypromine.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.