Tranylcypromine - Oral

Tranylcypromine is used to treat depression.

Take Tranylcypromine 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.

Try to take it at the same time each day.

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

Tranylcypromine 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:

• phaeochromocytoma (rare tumour of the adrenal gland causing high blood pressure)
• paraganglioma (rare tumour that forms from nerve cells in different body parts)
• disease of the blood vessels supplying the brain
• severe heart disease
• overactive thyroid gland
• blood disorder
• liver damage

as Tranylcypromine may not be suitable for you.

Do not take Tranylcypromine if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid and phenelzine in the last 14 days.

Do not take Tranylcypromine with medicines used to treat nasal congestion (stuffy nose), epilepsy (fits or seizures), 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) and migraine (severe throbbing pain or pulsating sensation usually affecting one side of the head and is often accompanied by nausea, vomiting, and sensitivity to light and sound). Please see the section "Can I take this with other medicines?" below for more information.

Inform your doctor if you have the following conditions:

• high blood pressure
• other heart problems
• fits or seizures
• history of drug or alcohol abuse
• history of self-harm or having thoughts of self-harm
• history of headaches
• diabetes
• low volume of circulating fluids in the body
• kidney disease

Let your doctor know if you are pregnant or breastfeeding.

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

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.

Medicines for depression such as Tranylcypromine 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.

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) 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 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.

Tranylcypromine 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: nausea, vomiting, diarrhoea, dry mouth, headache, dizziness, blurred vision, weight gain, and difficulty sleeping.

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

• having thoughts of self-harm or unusual changes in mood or behaviour (being too depressed, agitated, or having compulsive and impulsive behaviour)
• fast or irregular heartbeat, chest pain, sudden severe headache, excessive sweating with fever or cold, clammy skin
• yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles

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 Tranylcypromine if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid and phenelzine in the last 14 days.

Do not take Tranylcypromine with the following medicines:

• other medicines to treat depression e.g. amitriptyline, imipramine, fluoxetine, sertraline, mirtazapine, bupropion, nefazodone, vortioxetine
• medicines for nasal congestion e.g. phenylephrine, pseudoephedrine, ephedrine
• medicines for migraine
• certain medicines for high blood pressure e.g. reserpine, methyldopa
• certain strong painkillers e.g. pethidine, tapentadol
• levodopa (medicine for Parkinson's disease)
• dopamine (medicine for low blood pressure)
• carbamazepine (medicine for fits or seizures)
• tetrabenazine (medicine for movement disorder)
• buspirone (medicine for anxiety)
• cyclobenzaprine (medicine used to relieve muscle spasms)
• dextromethorphan (medicine used to relieve cough)

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

• other strong painkillers e.g. fentanyl, tramadol
• medicines for diabetes e.g. insulin
• medicines for cold or allergy
• other medicines for high blood pressure e.g. guanethidine
• metoclopramide (medicine for nausea and vomiting)
• lithium (medicine for mood disorders)

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

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. Ask your doctor or dietitian about the types of food you should avoid.

Store in a cool, dry place away from the reach of children.

Protect from light.

Medicines must not be used past the expiry date.