Tranylcypromine Sulfate(tran ill sip’ roe meen)
Parnate
PREGNANCY CATEGORY C
Drug Classes
Antidepressant
MAOI
Therapeutic Actions
Irreversibly inhibits MAO, an enzyme that breaks down biogenic amines, such as epinephrine, norepinephrine, and serotonin, allowing these biogenic amines to accumulate in neuronal storage sites; according to the biogenic amine hypothesis, this accumulation of amines is responsible for the clinical efficacy of MAOIs as antidepressants.
Indications
Treatment of adult outpatients with a major depressive episode without melancholia who have failed to respond to more commonly used antidepressants; efficacy in endogenous depression has not been established
Unlabeled uses: Migraine headache, panic disorder, social anxiety disorder, bipolar depression, Alzheimer disease, Parkinson disease
Contraindications and Cautions
Contraindicated with hypersensitivity to any MAOI; pheochromocytoma, HF; history of liver disease or abnormal LFTs; severe renal impairment; confirmed or suspected cerebrovascular defect; CV disease, hypertension; history of headache (headache is an indicator of hypertensive reaction to drug); myelography within previous 24 hr or scheduled within 48 hr; lactation; patients scheduled for elective surgery (MAOIs should be discontinued 10 days before surgery).
Available Forms
Tablets—10 mg
Dosages
Adults
Usual effective dose is 30 mg/day PO in divided doses. If no improvement is seen within 2–3 wk, increase dosage in 10 mg/day increments every 1–3 wk. May be increased to a maximum of 60 mg/day.
Pediatric patients
Not recommended for patients younger than 16 yr.
Geriatric patients
Patients older than 60 yr are more prone to develop side effects; use with caution.
Pharmacokinetics
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Metabolism: Hepatic; T1/2: Unknown
Distribution: Crosses placenta; enters breast milk
Excretion: Urine
