tranylcypromine sulfate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
tranylcypromine sulfate: clinical details
Prescribing considerations
- Reserve for adult major depressive episodes after other antidepressant types have failed.
- Obtain a complete prescription, over-the-counter, complementary-medicine and dietary history.
- Antidepressant switching requires specialist planning; avoid cross-tapering where serotonin toxicity is a risk.
- Review planned surgery, anaesthesia and dental procedures in advance.
- Withdraw gradually because abrupt cessation may cause withdrawal symptoms.
Contraindications and cautions
- Hepatic disease or abnormal liver function, severe cardiovascular or cerebrovascular disease, phaeochromocytoma, hyperthyroidism, porphyria or blood dyscrasia.
- Concurrent or insufficiently separated interacting MAOIs, serotonergic antidepressants, sympathomimetics, pethidine-related analgesics, nefopam, dextromethorphan, buspirone or bupropion.
- Hypersensitivity to tranylcypromine or an excipient.
Monitoring
- Monitor depressive symptoms, agitation, behavioural change and suicidality, particularly early in treatment and after treatment changes.
- Check blood pressure, including postural symptoms; older adults require especially careful monitoring.
- Monitor renal impairment clinically and review liver-related symptoms promptly.
- For people using glucose-lowering treatment, monitor for enhanced hypoglycaemic effects.
Clinical pharmacology
A non-hydrazine, irreversible inhibitor of MAO-A and MAO-B. It is rapidly absorbed, but pharmacodynamic enzyme inhibition continues substantially longer than its plasma presence.
Formulation and product differences
- The selected product is a round, beige film-coated tablet intended to be swallowed whole.
- It contains lactose and is unsuitable for certain rare hereditary disorders of galactose metabolism or absorption.
- It is supplied in opaque blister packs; marketed pack availability may vary.
tranylcypromine sulfate preparations and strengths
Tablet
Route: Oral
Strengths: 10 mg
tranylcypromine sulfate interactions
Tranylcypromine has numerous potentially serious interactions. Check every prescription, pharmacy medicine and supplement before use.
SSRIs, SNRIs and other serotonergic antidepressants
Combining or switching without an appropriate specialist plan can cause severe serotonin toxicity.
Tricyclic and tetracyclic antidepressants
The combination can cause severe hypertension and dangerous central nervous system excitation.
Decongestants and other sympathomimetics
Products containing agents such as pseudoephedrine, ephedrine or phenylephrine may trigger a hypertensive crisis.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.