Phenelzine

3
Phenelzine
Brands

DEA Class;  Rx

Common Brand Names; Nardil

  • Antidepressants, MAO Inhibitors

Non-selective monoamine oxidase A and B inhibitor (MAOI) antidepressant
FDA-approved for the treatment of major depressive disorder (MDD); used off-label as a second- or third-line agent for anxiety disorders such as panic disorder and social anxiety disorder
Primarily used for treatment-resistant cases of depression and anxiety disorders, due to dietary restrictions, adverse effect profile, and the potential for serious drug-drug interactions and drug-food interactions

Indicated for use in treatment-resistant depression, including atypical depression.

For the treatment of panic disorder.
For the treatment of social phobia (social anxiety disorder).

Hypersensitivity

Pheochromocytoma, congestive heart failure

Within 10 days of elective surgery using general anesthesia or spinal anesthesia

Liver disease, abnormal liver function tests, or history of hepatic disease

Renal disease, severe renal impairment, ESRD

Common

  • Orthostatic hypotension

  • Asthenia

  • Dizziness

  • Headache

  • Drowsiness

  • Fatigue

  • Hyperreflexia

  • Sleep disturbance

  • Somnolence

  • Weakness

  • Tremor

  • Constipation

  • Dry mouth

  • Weight gain

Less Common

  • Confusion

  • Decreased memory

  • Paresthesia

  • Anorexia

  • Nausea

  • Vomiting

  • Impotence

  • Increased LFT’s

  • Nystagmus

  • Urinary frequency or retention

Uncommon

  • Edema

  • Anxiety

  • Irritation

  • Hypomania

  • Hypermetabolic syndrome (hyperpyrexia, tachycardia, tachypnea, increased CPK, acidosis)

  • Arthralgia

  • SIADH

Rare

  • Hypertensive crisis

  • Ataxia

  • Seizure

  • Worsening depression

  • Suicide

  • Edema of glottis

  • Leukopenia

  • Hepatic necrosis, jaundice

  • Drug-induced lupus erythematosus

  • Visual disturbance

Orthostatic hypotension may occur

Hypertensive reactions may occur from consumption of foods high in tyramine or supplements containing caffeine, tyrosine, tryptophan, phenylalanine, or phenylalanine

Not first-line therapy

Discontinue 10 days before surgery

Therapy not approved for treating any indications in the pediatric population

Most serious reactions involve changes in blood pressure

Therapy may cause excessive stimulation in schizophrenic patients

Drug potentiates hexobarbital hypnosis in animals; barbiturates should be given at a reduced dose with phenelzine

Drug should be used with caution in diabetes mellitus; increased insulin sensitivity may occur; requirements for insulin or oral hypoglycemics may be decreased; there is conflicting evidence as to whether or not MAO inhibitors affect glucose metabolism or potentiate hypoglycemic agents; this should be kept in mind if drug is administered to diabetics

Pregnancy Category: C

Lactation: unknown; use caution

Adults

90 mg/day PO.

Geriatric

90 mg/day PO.

Adolescents

Safety and efficacy have not been established.

Children

Safety and efficacy have not been established.

Phenelzine sulfate 

tablet

  • 15mg
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