Parnate

The active ingredient in Parnate is tranylcypromine sulfate. Tranylcypromine belongs to a class of medications known as monoamine oxidase inhibitors (MAOIs). It is not fully understood how exactly Parnate helps with depression. However, it is thought that the effects of tranylcypromine are due to it stopping the breakdown of certain neurotransmitters in the brain, which are often imbalanced in those with depression. These include serotonin, dopamine, and norepinephrine. Other MAO inhibitors include phenelzine and selegiline.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide, before using Parnate. However, the following is a synopsis of the general guidelines for the use of Parnate:

• Parnate should be used exactly as prescribed. Your exact regimen and dosing will be highly individualized. Your prescriber will continue to adjust the dose over time depending on your response until they find one that is right for you.
• Parnate is typically taken in divided doses multiple times a day with or without food. Do not stop Parnate abruptly. Sudden discontinuation could lead to withdrawal symptoms.
• Do not take Parnate with foods or beverages that contain a high amount of tyramine during treatment or for 2 weeks after stopping. Doing so could put you at an increased risk of cardiovascular adverse events. Such foods or beverages include:

--- Air-dried, aged, and fermented meats, sausages, and salamis

--- Pickled herring

--- Any spoiled or improperly stored meat, poultry, and fish

--- Fava beans

--- Aged cheeses

--- All tap beers and any that have not been pasteurized

--- Concentrated yeast extract (Marmite)

--- Soybean products (including soy sauce and tofu)

--- Sauerkraut

--- OTC supplements with tyramine

• Do not drive or operate heavy machinery while on Parnate until you know how it affects you.
• Do not drink alcohol while taking Parnate.
• If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take double doses to make up for a missed one.

The most common side effects of Parnate include:

• Dry mouth
• Dizziness
• Insomnia
• Sedation and drowsiness
• Headache
• Overexcitement
• Constipation
• Blurred vision
• Tremor

Some individuals may experience serious side effects while using Parnate. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Signs of suicidal ideation or behaviors such as sudden changes in mood, behaviors, thoughts, or emotions, including worsening depression, suicidal thoughts, aggression, sleep issues, mania, panic attacks, or other unusual changes
• Signs of a hypertensive crisis (a sudden, severe increase in blood pressure) such as a sudden, severe headache, nausea, vomiting, fast heartbeat, heart palpitations, chest pain, pupil dilation, stiff or sore neck, excessive sweating, and photophobia (increased sensitivity to light)
• Signs of serotonin syndrome such as agitation, confusion, sweating, high body temperature, seizures, hallucinations, rapid pulse, dizziness, flushing, tremor, muscle twitching, nausea, vomiting, and diarrhea
• Signs of a manic episode such as greatly increased energy, racing thoughts, talking more or faster than usual, severe sleeping problems, reckless behavior, and excessive happiness or irritability
• Seizures or convulsions
• Signs of low blood sugar or hypoglycemia, such as sweating, dizziness, fatigue, irritability, and sleep issues
• Signs of liver problems, such as nausea, vomiting, loss of appetite, and yellowing of the skin or eyes

These are not all of the possible side effects of Parnate. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Parnate, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including whether you have:

• High blood pressure (hypertension)
• Low blood pressure (hypotension)
• Heart problems
• Cerebrovascular and nervous system problems, including stroke
• Headaches
• Personal or family history of bipolar disorder, mania, or hypomania
• Plans for surgery
• Liver problems
• Thyroid problems
• History of seizures or convulsions
• Diabetes
• Are pregnant or plan to become pregnant
• Are breastfeeding or plan to breastfeed

Boxed Warning

• Antidepressants are associated with an increased risk of suicidal thoughts and behaviors in pediatric patients and young adults (<24 years of age). All patients taking antidepressants should be monitored closely for clinical worsening and suicidal ideation. Parnate is not approved for use in pediatric patients.
• When Parnate is taken alongside certain medications or foods/beverages with a high tyramine content, it can lead to a hypertensive crisis, which can then lead to stroke and death. Do not use them together.

Do not use Parnate if you have:

• Pheochromocytoma (tumor on the adrenal gland)
• Are taking certain medications like antidepressants (TCAs, SSRIs, SNRIs, and bupropion) and medications for migraines, allergies, weight loss, and cough and cold

It can take weeks of regular use to see the full benefits of Parnate.

When Parnate is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• Altretamine
• Amphetamines, methylphenidates, and their derivatives
• Antidepressants, including other MAOIs (such as rasagiline), selective serotonin reuptake inhibitors or SSRIs (such as fluoxetine), SNRIs (such as duloxetine or milnacipran), tricyclic antidepressants, amoxapine, bupropion, maprotiline, mirtazapine, nefazodone, trazodone, vilazodone, and vortioxetine
• Antiglycemics or diabetes medications
• Antihypertensives or blood pressure medications
• Beta-blockers
• Buspirone
• Carbamazepine
• Chlorpromazine
• Cyclobenzaprine
• Dextromethorphan
• Dopamine
• Droperidol
• Entacapone
• Hydroxytryptophan and tryptophan
• Hypnotics
• Levodopa and methyldopa
• Lithium
• Metoclopramide
• Non-selective H1 receptor antagonists such as diphenhydramine
• Opioids, including fentanyl, methadone, meperidine, and tramadol
• Oxcarbazepine
• Reserpine
• SAM-e
• Sedatives
• St. John’s Wort
• Sympathomimetics such as pseudoephedrine, phenylephrine, and ephedrine
• Tapentadol
• Tetrabenazine
• Tolcapone
• Triptans

Parnate is available as a single dosage form and strength, which is 10 mg tablets.

Parnate should be stored at room temperature, away from light and moisture, and out of reach of children.

Parnate is manufactured by the pharmaceutical company Advanz Pharma.

Yes, there is a generic available for the brand-name Parnate.

Abruptly stopping Parnate can cause withdrawal effects such as dizziness, nausea, headache, irritability, insomnia, diarrhea, anxiety, fatigue, abnormal dreams, and increased sweating. The risk of withdrawal is higher with long-term use. A gradual reduction in Parnate over time is preferred to reduce the risk of withdrawal. Consult your doctor or pharmacist before starting, stopping, or changing medications while taking Parnate.

Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

Parnate can pass into the breast milk. Do not breastfeed during treatment with Parnate. Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.