Nardil Tablets

• Most people start on one 15mg tablet three times a day. Your doctor will decide what dose is best for you. Follow the instructions on the label and do not change the dose unless your doctor tells you to.
• It may take four weeks before you feel the full effect of the tablets. Your doctor will want to see you regularly during this time and will also take your blood pressure.

Could it interact with other tablets?

Nardil can react with some other medicines including those bought without a prescription. Always tell your doctor, dentist and pharmacist that you are taking Nardil.

Nardil may interact with:

• Cough and cold cures, hay fever medications, asthma inhalant medications, antiappetite medicines, weight-reducing preparations and ‘pep’ pills.
• Strong pain killers (pethidine and morphine).
• Tryptophan, amphetamines and medicines of the type known as sympathomimetic amines (adrenaline (epinephrine), fenfluramine, ephedrine, phenylpropanolamine, dopamine and levodopa). Cough medicine containing dextromethorphan. Some of these may be in cold cures and other medicines bought without a prescription.
• Medicines used to treat high blood pressure (particularly guanethidine), diabetes and antimuscarinics used to treat motion sickness, relieve muscle cramps in the gut or bladder or Parkinson’s disease, medicines which make you sleepy (including barbiturates and alcohol) and local anaesthetics including cocaine. The effect of these medicines may be increased by Nardil.
• Amfebutamone (used to help you give up smoking) and 5HT1 agonists (used to treat migraine). These medicines should not be taken at the same time as, or within 14 days of, Nardil.
• Medicines used to treat epilepsy, altretamine (used to treat ovarian cancer), doxapram (used to stimulate breathing in emergency situations), tetrabenazine (used to treat Huntington’s chorea), oxypertine and clozapine (used to treat schizophrenia and other similar illnesses). Check with your doctor or pharmacist before taking Nardil, if you are taking any of these medicines.
• Antidepressants of the type known as tricyclic antidepressants. These antidepressants and Nardil are not usually given within 14 days of each other. However, sometimes they may be used together if great care is taken and your doctor feels it is appropriate.
• Other antidepressants. Nardil should not be taken for 14 days either before or after taking another Monoamine Oxidase Inhibitor (MAOI), buspirone or dibenzazepine derivative drugs e.g. tricyclic antidepressant agents, perphenazine or carbamazepine. If you have been taking clomipramine or imipramine, 3 weeks should be left before starting Nardil.

Nardil should not be used at the same time as Selective Serotonin Re-uptake Inhibitors (SSRI) or Serotonin Noradrenaline Re-uptake Inhibitors (SNRI) e.g. venlafaxine - your doctor or pharmacist can tell you if you are taking these types of drugs.

If you are taking SSRIs, then a sufficient amount of time needs to be left to allow the drug and its by-products to leave the body before you can start taking Nardil. Also, do not start taking an SSRI or SNRI until 14 days after finishing taking Nardil.

Herbal products should also only be taken after talking with your doctor.

Nardil and Food
Nardil interacts with a substance called tyramine which is found in some foods. If you eat a food containing tyramine while you are taking Nardil, or within 14 days of taking Nardil, you may have a very severe rise in blood pressure. This will happen soon after eating the food and you may get a violent headache, pounding heart, stiff neck, flushing, sweating or you may be sick. The severity of the reaction depends on the amount of tyramine you eat and may be mild or may be dangerous, even fatal. If you feel such a reaction happening, tell your doctor at once.

Do not eat: Cheese (cooked or plain), liver, yoghurt, yeast extracts (e.g. Marmite), Oxo, Bovril, Brewer’s yeast, flavoured textured vegetable protein, broad bean pods, protein which has been allowed to age, degrade or ferment (e.g. hung game, pickled herrings or dry sausage such as salami or pepperoni), fermented soya bean extract, excessive amounts of chocolate.

Do not drink: Alcohol, non-alcoholic beer, lager or wine. You may drink a reasonable amount of tea or coffee but not to excess.

What are the possible risks or side-effects?

Nardil can sometimes cause side effects. These are usually mild or moderate in severity and tend to go away as treatment continues. The most serious reaction is high blood pressure and happens most commonly when the wrong food is eaten (see “Nardil and Food” section).

Other reactions are:

• Drowsiness, dizziness, weakness, tiredness and blurred vision (see “Nardil and Driving”).
• Low blood pressure when standing or sitting up. You may feel giddy and about to faint.

This effect is more common in the elderly.

• Water retention (can cause swollen ankles), nausea, vomiting, dry mouth, constipation, insomnia, twitching, increased reflexes and difficulty in achieving an orgasm are sometimes seen.
• Headache, nervousness, excitement, loss of feeling in hands and feet, sweating, increased appetite and weight, rash, itching, difficulty in passing urine, shaking, nerve pain, changes in the rhythm of the heart, fits, impotence, delayed ejaculation, changes in normal behaviour, bruising, changes of the blood, jitteriness, speech changes (repeating the last word of a sentence), unusual eye movements, too much sodium (salt) in the blood, too much pressure in the eye-ball (glaucoma), lupus-like illness (a disease affecting the immune system), confusion, hallucinations and high levels of liver enzymes have been seen on rare occasions.

Nardil and driving:

This medicine may make you sleepy. If this happens, do not drive or use tools or machinery.

Can I drink alcohol while taking it?

You cannot drink alcohol while taking Nardil.

What if I’m pregnant/breastfeeding?

Nardil should not be used while pregnant or breast feeding.

If you have any more questions please ask your Pharmacist.

Remember to keep all medicines out of reach of children
Please Note: We have made every effort to ensure that the content of this information sheet is correct at time of publish, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.

References:

https://www.medicines.org.uk/emc/medicine/18541

http://www.drugs.com/cdi/nardil.html

https://en.wikipedia.org/wiki/Phenelzine

http://www.rxlist.com/nardil-drug.htm

https://www.pfizer.com/files/products/uspi_nardil.pdf

https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682089.html