Marplan

What is Marplan (isocarboxazid)?

Isocarboxazid is a monoamine oxidase inhibitor (MAOI) that works by increasing the levels of certain chemicals in the brain.

Isocarboxazid is used to treat symptoms of depression that may include anxiety, panic, or phobias. This medication is usually given after other antidepressants have been tried without successful treatment of symptoms.

Isocarboxazid may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Marplan (isocarboxazid)?

There are many other medicines that can cause serious or life-threatening medical problems if you take them together with isocarboxazid. Do not take isocarboxazid before telling your doctor about all other prescription and over-the-counter medications you use, including vitamins, minerals, and herbal products. Keep a list with you of all the medicines you use and show this list to any doctor, dentist, or other healthcare provider who treats you.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

You should become very familiar with the list of foods and medicines you must avoid while you are taking isocarboxazid.

What should I discuss with my doctor before taking Marplan (isocarboxazid)?

Do not use this medication if you have used another MAOI such as phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take isocarboxazid before another MAOI has cleared from your body. Do not take this medication if you are allergic to isocarboxazid, or if you have:

• pheochromocytoma (tumor of the adrenal gland);

• a history of stroke or blood clots;

• liver disease;

• kidney disease;

• heart disease;

• high blood pressure; or

• a history of severe or frequent headaches.

There are many other medicines that can cause serious or life-threatening medical problems if you take them together with isocarboxazid. The following drugs should not be used while you are taking isocarboxazid:

• diet pills, caffeine, stimulants, ADHD medication, asthma medication, over-the-counter cough and cold or allergy medicines;

• blood pressure medication;

• diuretics (water pills);

• bupropion (Wellbutrin, Zyban);

• buspirone (BuSpar); or

• carbamazepine (Carbatrol, Tegretol);

• furazolidone (Furoxone);

• meperidine (Demerol, Mepergan);

• pargyline (Eutonyl);

• procarbazine (Matulane);

• alcohol or medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety).

• antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adepin, Sinequan), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil); or

• antidepressants such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

Before taking isocarboxazid, tell your doctor if you have:

• high blood pressure, heart disease;

• diabetes;

• liver or kidney disease;

• a thyroid disorder;

• schizophrenia;

• epilepsy or other seizure disorder;

• if you have taken another antidepressant within the past 5 weeks; or

• if you are also taking tryptophan (also called L-tryptophan), guanethidine (Ismelin), levodopa (Larodopa, Parcopa, Sinemet), or methyldopa (Aldomet).

If you have any of these conditions, you may not be able to use isocarboxazid, or you may need a dosage adjustment or special tests during treatment.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

How should I take Marplan (isocarboxazid)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results from this medication.

To be sure this medication is not causing harmful effects, your blood pressure will need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of an isocarboxazid overdose may include shallow breathing, fast heart rate, sweating, fever, slow reflexes, feeling light-headed, fainting, or seizure (convulsions).

What should I avoid while taking Marplan (isocarboxazid)?

While you are taking isocarboxazid you must not eat foods that are high in tyramine, including:

• cheese (especially strong or aged cheeses);

• sour cream;

• beer (including non-alcoholic beer), sherry, Chianti wine, liquers;

• dry sausage (such as hard salami, pepperoni, anchovies, caviar, liver, pickled herring;

• canned figs, raisins, bananas;

• avocados;

• chocolate or caffeine;

• soy sauce;

• sauerkraut;

• fava beans;

• yeast extracts;

• yogurt;

• meat extracts;

• meat prepared with tenderizer; or

• over-the-counter supplements or cough and cold medicines that contain dextromethorphan or tyramine.

You should become very familiar with the list of foods and medicines you must avoid while you are taking isocarboxazid. Eating tyramine while you are taking isocarboxazid can raise your blood pressure to dangerous levels which could cause life-threatening side effects.

Marplan (isocarboxazid) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

• sudden and severe headache, rapid heartbeat, stiffness in your neck, nausea, vomiting, cold sweat, sweating, vision problems, sensitivity to light;

• chest pain, fast or slow heart rate;

• swelling, rapid weight gain;

• jaundice (yellowing of the skin or eyes); or

• feeling light-headed, fainting.

Continue taking this medication and talk to your doctor if you have any of these less serious side effects:

• dizziness, headache;

• tremors or shaking;

• constipation,nausea; or

• dry mouth.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Marplan (isocarboxazid)?

There are many other medicines that can cause serious or life-threatening medical problems if you take them together with isocarboxazid. Do not take isocarboxazid before telling your doctor about all other prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor, dentist, or other healthcare provider who treats you.

Where can I get more information?

• Your pharmacist has more information about isocarboxazid written for health professionals that you may read.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.