Tranylcypromine Stats & Data

Irreversible MAOI: although the parent drug’s plasma half-life is ~1.5–3.2 hours, enzyme inhibition persists until new MAO is synthesized, so interaction risks remain for at least 14 days after stopping (and often 10–21 days). Maintain a 14‑day washout when switching to or from serotonergic antidepressants; extend to 5 weeks after fluoxetine due to its long half-life. Hypertensive crisis (“cheese reaction”) can occur from dietary tyramine or sympathomimetic drugs; earliest sign is often a severe occipital headache, and can progress to chest pain, palpitations, shortness of breath, confusion, and seizures — seek emergency care immediately. Serotonin syndrome risk is high if combined with serotonergic medicines (e.g., SSRIs/SNRIs, clomipramine, MDMA, tramadol, DXM, linezolid, methylene blue); symptoms include agitation, hyperreflexia, clonus, fever, diaphoresis, diarrhea — urgent evaluation is required. Avoid OTC cold/cough products that contain dextromethorphan or decongestants (pseudoephedrine, phenylephrine); many carry a label warning against use within 14 days of an MAOI. Follow a low‑tyramine diet throughout therapy and for 2 weeks after stopping; avoid aged cheeses, cured/fermented meats, soy sauce/miso/yeast extracts, fava beans, and tap/draft beers; packaged spirits in modest amounts still require caution for hypotension/CNS effects. For planned surgery or dental procedures, inform anesthesia providers; some agents (e.g., meperidine, serotonergic antiemetics) are contraindicated, and perioperative plans may need adjustment. Tranylcypromine has a stimulant-like profile and can cause insomnia and orthostatic hypotension; dosing earlier in the day and dividing doses may reduce insomnia and BP swings. Rare hepatotoxicity has been reported; baseline and periodic liver function and blood pressure monitoring are prudent in clinical use. Carry an MAOI alert card/bracelet listing key contraindications (meperidine, DXM, serotonergic antidepressants, sympathomimetics) so emergency staff can avoid dangerous drugs.