Phenelzine - Oral

Phenelzine is used to treat a certain type of depression in individuals who have not responded to other medicines for depression.

Take Phenelzine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.

Phenelzine must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it suddenly as this may worsen your condition.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Alert your doctor if you have the following conditions:

• cerebrovascular disease (disease of the blood vessels supplying the brain)
• phaeochromocytoma (rare tumour of the adrenal gland causing high blood pressure)
• congestive heart failure (weakness and inability of the heart to pump blood)
• liver disease
• severe kidney disease

as Phenelzine may not be suitable for you.

Do not take Phenelzine with medicines used to treat depression known as monoamine oxidase inhibitor (MAOI), medicines used to relieve cough, medicines for epilepsy (fits or seizures), and strong painkillers. Please see the section "Can I take this with other medicines?" below for more information.

Inform your doctor if you have the following conditions:

• diabetes
• hyperthyroidism (overactive thyroid gland)
• glaucoma (increased pressure in the eye)
• blood disorders
• heart disease
• predisposing conditions to epilepsy (fits or seizures) e.g. head trauma, brain damage, alcoholism

Let your doctor know if you are pregnant or breastfeeding.

Be sure to check with your doctor or pharmacist before giving Phenelzine to the elderly. Elderly people may be more sensitive to the side effects.

Notify your doctor if you have recently undergone or will undergo electroshock therapy (also known as electroconvulsive therapy or ECT).

Medicines for depression such as Phenelzine may increase the risk of suicidal thoughts and behaviour. As depression and some psychiatric disorders are themselves associated with an increased risk of suicide, it is important for you or your family members to monitor your condition, especially at the start of treatment and if your dosage is still being adjusted. If you experience new or sudden changes in mood, behaviour, thoughts or feelings or a worsening of your depression with suicidal thoughts or attempts, harm to self or harm to others, contact your doctor immediately.

If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking this medicine.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. liver and kidney function, sugar levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Your blood pressure may rise or fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.

What lifestyle changes should I make to cope with depression?

Regular exercise and eating a healthy diet will help increase energy and hormones in the body such as serotonin, endorphins and other feel-good chemicals that minimise mood swings. Get enough sleep, as lack of sleep may cause irritability, moodiness, sadness, and tiredness.

Phenelzine may cause drowsiness. If affected, do not drive or take part in any activity in which you need to be alert.

This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.

Other side effects include any of the following: blurred vision, constipation, nausea, weakness, tiredness, and difficulty sleeping.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• severe headache, chest pain, shortness of breath, vomiting
• agitation, confusion, hallucinations (seeing, hearing or feeling things that are not existent), fever, fast heartbeat, excessive sweating, muscle stiffness or spasms
• having thoughts of self-harm
• unusual changes in mood or behaviour (being too depressed, agitated, or having compulsive and impulsive behaviour)
• numbness or tingling sensation in the hands and feet

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Do not take Phenelzine if you are currently taking or have taken the following medicines in the last 14 days:

• other medicines to treat depression e.g. bupropion, sertraline, venlafaxine, duloxetine, amitriptyline, isocarboxazid, tranylcypromine
• methyldopa (medicine for high blood pressure)
• levodopa (medicine for Parkinson's disease [disorder that affects the movement of a person, causing symptoms such as tremors, muscle stiffness, slowed movement and impaired balance or walking])
• buspirone (medicine for anxiety)
• carbamazepine (medicine for epilepsy [fits or seizures])
• perphenazine (medicine for mood disorders)

Do not take this medicine if you are currently taking or have taken fluoxetine (medicine to treat depression) in the last 5 weeks.

Do not take Phenelzine with the following medicines:

• dextromethorphan (medicine used to relieve cough)
• guanethidine (medicine for high blood pressure)
• apraclonidine (medicine for glaucoma [increased pressure in the eye])
• strong painkillers e.g. morphine

Inform your doctor and pharmacist if you are taking any of these medicines:

• medicines for diabetes
• other medicines for high blood pressure

This list does not include all medicines that may interact with Phenelzine.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol and other drinks that contain tyramine such as red wine and beer.

Avoid foods that are rich in tyramine, such as cheese, sausages, soya beans, fava beans, broad beans, and pickled foods like sauerkraut. Also avoid excessive amounts of chocolate, tea, and coffee.

It may be helpful to discuss your diet with your doctor or dietitian.

Available products of Phenelzine may vary with its storage requirements. Ask your doctor or pharmacist on how to properly store this medicine.

Medicines must not be used past the expiry date.