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All about: Isocarboxazid

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Generic Name: Isocarboxazid (eye-soe-kar-BOX-a-zid)
Brand Name: Marplan

The risk of suicidal thinking and behavior was increased by antidepressants in short-term studies in children and adolescents with certain psychiatric disorders. Anyone considering the use of Isocarboxazid or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be watched closely for worsening of symptoms, suicidal thoughts and behavior, or unusual behavior changes. Families and caregivers should be aware of the need for close observation and communication with the prescriber.

Results from several studies in children and adolescents with certain psychiatric disorders have revealed a greater risk of side effects related to suicidal thinking and behavior during the first few months of treatment with antidepressants.

Isocarboxazid is used for:

Treating short-term (up to 6 weeks) depression in patients who do not respond to other medications. It may also be used for other conditions as determined by your doctor.

Isocarboxazid is a monoamine oxidase (MAO) inhibitor. It works by increasing certain chemicals in the brain that help elevate mood.

Do NOT use Isocarboxazid if:

  • you are allergic to any ingredient in Isocarboxazid
  • you have high blood pressure, heart or brain blood vessel disease or problems, heart failure, liver problems, severe kidney problems, severe or frequent headache, an adrenal gland tumor (pheochromocytoma), or schizophrenia
  • you will be having surgery
  • you are eating cheese or other foods with a high tyramine content, are taking high amounts of caffeine, or you abuse alcohol
  • you are taking an anorexiant (eg, phentermine), an antihypertensive (eg, hydrochlorothiazide), apraclonidine, bupropion, buspirone, carbamazepine, cyclobenzaprine, dextromethorphan, ethanol, levodopa, meperidine, methotrimeprazine, methylphenidate, nefazodone, propoxyphene, a selective serotonin reuptake inhibitor (SSRI) (eg, fluoxetine), a serotonin-norepinephrine reuptake inhibitor (SNRI) (eg, atomoxetine), sibutramine, a sympathomimetic (eg, albuterol, amphetamine), a tetracyclic antidepressant (eg, trazodone), or a tricyclic antidepressant (eg, amitriptyline), or you have taken another MAO inhibitor (eg, phenelzine) within the last 14 days

Contact your doctor or health care provider right away if any of these apply to you.

Before using Isocarboxazid :

Some medical conditions may interact with Isocarboxazid . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have asthma, mental or mood disorders (eg, bipolar mood disorder), bronchitis, an irregular heartbeat, diabetes, epilepsy, thyroid problems, certain types of heart disease, Parkinson disease, the blood disorder porphyria, kidney problems, stroke, or suicidal thoughts or behaviors

Some MEDICINES MAY INTERACT with Isocarboxazid . Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Apraclonidine, bupropion, buspirone, carbamazepine, cyclobenzaprine, dextromethorphan, ethanol, meperidine, methotrimeprazine, phenothiazines (eg, thioridazine), propoxyphene, SNRIs (eg, atomoxetine), or tricyclic antidepressants (eg, amitriptyline) because side effects such as high blood pressure may be increased
  • Antihypertensives (eg, hydrochlorothiazide), anorexiants (eg, phentermine), catechol-O-methyltransferase (COMT) inhibitors (eg, entacapone), insulin, levodopa, meglitinide antidiabetics (eg, repaglinide), methylphenidate, sibutramine, SSRIs (eg, fluoxetine), sulfonylureas (eg, glipizide), sumatriptan, sympathomimetics (eg, albuterol, amphetamine), tetracyclic antidepressants (eg, trazodone), or tramadol because the actions and side effects of these medicines may be increased
  • Disulfiram, nefazodone, other MAO inhibitors (eg, phenelzine), or tryptophan because severe unexpected toxicity may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Isocarboxazid may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Isocarboxazid :

Use Isocarboxazid as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Isocarboxazid comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get Isocarboxazid refilled.
  • Isocarboxazid may be taken with or without food.
  • It may take 3 to 6 weeks for you to see the effects of Isocarboxazid . Continue taking your medicine during this time.
  • Continue to take Isocarboxazid even if you feel better. Do not miss any doses.
  • If you miss a dose of Isocarboxazid , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Isocarboxazid .

Important safety information:

  • Isocarboxazid may cause drowsiness or dizziness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Isocarboxazid . Using Isocarboxazid alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
  • Avoid drinking alcohol or taking other medicines that cause drowsiness (eg, sedatives, tranquilizers) while taking Isocarboxazid . Isocarboxazid will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
  • Isocarboxazid may cause dizziness, lightheadedness, or fainting. Alcohol, hot weather, exercise, and fever can increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness, lightheadedness, or weakness.
  • Antidepressants can increase suicidal thoughts and behaviors in some children and teenagers. This risk may be higher in individuals with bipolar illness (also called manic-depressive illness), a family history of bipolar illness, or a history of attempting suicide. Pay close attention to changes in moods or actions, especially if changes occur suddenly. Contact your health care provider right away if any of the following effects occur or worsen: depression, anxiety, restlessness or irritability, panic attacks, thoughts or attempts of suicide, or other unusual changes in behavior or mood.
  • Avoid large amounts of caffeine-containing foods and beverages, such as coffee, tea, cocoa, cola drinks, and chocolate. If you have questions about how much is excessive, ask your doctor.
  • Isocarboxazid may cause serious increases in blood pressure if certain foods are eaten. Avoid eating foods such as aged cheeses, sour cream, red wines, beer, bologna, pepperoni, salami, summer sausage, pickled herring, liver, meat prepared with tenderizers, canned figs, raisins, bananas, avocados, soy sauce, fava beans, or yeast extracts. Obtain a complete list of foods and beverages from your doctor or pharmacist.
  • Additional monitoring of your condition is recommended at the start of treatment with Isocarboxazid and whenever a change to your dose is made.
  • Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Isocarboxazid .
  • Diabetes patients - Isocarboxazid may affect your blood sugar. Check blood sugar levels closely and ask your doctor before adjusting the dose of your diabetes medicine.
  • Use Isocarboxazid with caution in the ELDERLY because they may be more sensitive to its effects.
  • Isocarboxazid is not recommended for use in CHILDREN younger than 16 years of age. Safety and effectiveness in this age group have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Isocarboxazid during pregnancy. It is unknown if Isocarboxazid is excreted in breast milk. If you are or will be breast-feeding while you are using Isocarboxazid , check with your doctor or pharmacist to discuss the risks to your baby.

When used for long periods of time or at high doses, some people develop a need to continue taking Isocarboxazid . This is known as DEPENDENCE or addition.

If you suddenly stop taking Isocarboxazid you may experience WITHDRAWAL symptoms including anxiety; confusion; depression; diarrhea; hallucinations; headaches; restlessness; and weakness.

Possible side effects of Isocarboxazid :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Abnormal skin sensations; anxiety; blurred vision; chills; constipation; diarrhea; dizziness; drowsiness; dry mouth; fainting; forgetfulness; frequent urination; headache; heavy feeling; hyperactivity; inability to urinate; lack of energy; lightheadedness when rising from a seated or lying position; muscle jerks; nausea; sedation; sleep disturbance; sleeplessness; tremors; upset stomach.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); agitation; chest pain; cold, clammy skin; difficulty sleeping; fast or irregular heartbeat; feelings of irritability or hostility; impotence; impulsive behavior or other unusual change in behavior; nausea; neck stiffness; panic attacks; pounding in the chest; sensitivity to light; severe headache; severe high blood pressure; severe nervousness or anxiety; severe restlessness; suicidal thoughts or behaviors; sweating; tightness in the throat or chest; vomiting; widened pupils; worsening feelings of depression; yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include agitation; anxiety; cold, clammy skin; coma; confusion; difficulty breathing; dizziness; drowsiness; excitement; faintness; fast breathing; fast heartbeat; fever; flushing; hallucinations; headache; high blood pressure with a severe headache; hyperactivity; incoherence; irritability; jaw stiffness; low blood pressure; movement disorders including grimacing and rigidity; restlessness; seizures; shock; sleeplessness; sweating; unusual muscle movements; weakness.

Proper storage of Isocarboxazid :

Store Isocarboxazid at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Isocarboxazid out of the reach of children and away from pets.

General information:

  • If you have any questions about Isocarboxazid , please talk with your doctor, pharmacist, or other health care provider.
  • Isocarboxazid is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Isocarboxazid . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: September 5, 2007
Database Edition
Copyright © 2007 Wolters Kluwer Health, Inc.

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