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Generic Name: phenelzine (FEN el zeen)
Brand Name: Nardil
Nardil is a monoamine oxidase inhibitor (MAOI) that works by increasing the levels of certain chemicals in the brain.
Nardil is used to treat symptoms of depression that may include feelings of sadness, fear, anxiety, or worry about physical health (hypochondria). This medication is usually given after other anti-depressants have been tried without successful treatment of symptoms. This medicine is not for treating severe depression or bipolar disorder (manic depression).
Nardil may also be used for other purposes not listed in this medication guide.
There are many other medicines that can cause serious or life-threatening medical problems if you take them together with Nardil. Do not take this medicine before telling your doctor about all other prescription and over-the-counter medications you use, including vitamins, minerals, and herbal products. Keep a list with you of all the medicines you use and show this list to any doctor, dentist, or other healthcare provider who treats you.
You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
While you are taking Nardil, you must not drink alcohol or eat foods that are high in tyramine, listed in the "What should I avoid while taking this medicine?" section of this leaflet. Eating tyramine while you are taking this medicine can raise your blood pressure to dangerous levels, causing symptoms that include sudden and severe headache, rapid heartbeat, stiffness in your neck, nausea, vomiting, cold sweat, vision problems, and sensitivity to light. Stop taking this medicine and call your doctor at once if you have any of these symptoms.
Nardil may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Do not use this medication if you have used another MAOI such as isocarboxazid (Marplan), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take Nardil before another MAOI has cleared from your body.
Do not take Nardil if you are allergic to it, or if you have:
pheochromocytoma (tumor of the adrenal gland);
congestive heart failure;
a history of liver problems; or
if you need any type of surgery with anesthesia.
There are many other medicines that can cause serious or life-threatening medical problems if you take them together with Nardil. The following drugs should not be used while you are taking this medicine:
diet pills, caffeine, stimulants, ADHD medication, asthma medication, over-the-counter cough and cold or allergy medicines;
tryptophan (also called L-tryptophan);
levodopa (Larodopa, Parcopa, Sinemet), methyldopa (Aldomet);
meperidine (Demerol, Mepergan);
furazolidone (Furoxone);
procarbazine (Matulane);
buspirone (BuSpar);
bupropion (Wellbutrin, Zyban);
dexfenfluramine (Redux);
guanethidine (Ismelin);
alcohol or medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety); or
antidepressants such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor).
If you have any of these other conditions, you may need a Nardil dose adjustment or special tests:
high blood pressure, heart disease;
diabetes;
schizophrenia;
epilepsy or other seizure disorder; or
if you have taken another antidepressant within the past 5 weeks.
You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.
Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
FDA pregnancy category C. It is not known whether Nardil will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication..
It is not known whether phenelzine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Your doctor may occasionally change your dose to make sure you get the best results.
Your blood pressure will need to be checked often. Visit your doctor regularly.
It may take several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 4 weeks of treatment.
Store at room temperature away from moisture and heat.
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include feeling drowsy or dizzy, severe headache, neck pain or stiffness, hallucinations, shallow breathing, fast and uneven heart rate, cold sweats, feeling like you might pass out, or seizure (convulsions).
While you are taking Nardil you must not eat foods that are high in tyramine, including:
aged or smoked meats, fermented meats, dry sausage (including salami, pepperoni, Lebanon bologna), liver, pickled herring;
any spoiled or improperly stored meats, fish, or dairy products;
beer and wine (including non-alcoholic beer or wine);
cheese (other than cottage cheese or cream cheese);
sauerkraut;
over-the-counter supplements or cough and cold medicines that contain dextromethorphan or tyramine;
large amounts of chocolate or caffeine;
yogurt;
fava beans;
meat extracts; or
yeast extracts (including Brewer's yeast).
You should become very familiar with the list of foods and medicines you must avoid while you are taking Nardil. Eating tyramine while you are taking this medicine can raise your blood pressure to dangerous levels which could cause life-threatening side effects.
Nardil may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Stop using Nardil and call your doctor at once if you have any of these serious side effects:
sudden and severe headache, rapid heartbeat, stiffness in your neck, nausea, vomiting, cold sweat, sweating, vision problems, sensitivity to light;
chest pain, fast or slow heart rate;
swelling, rapid weight gain;
agitation, unusual thoughts or behavior; or
feeling light-headed, fainting.
Less serious side effects may include:
dizziness;
feeling weak or drowsy;
sleep problems (insomnia);
constipation, upset stomach;
dry mouth, decreased urination; or
impotence, difficulty having an orgasm.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
There are many other medicines that can cause serious or life-threatening medical problems if you take them together with Nardil. Do not take this medicine before telling your doctor about all other prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor, dentist, or other healthcare provider who treats you.
Further informationRemember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/27/2021.
Source: Drugs.com Nardil (www.drugs.com/mtm/nardil.html).
Note: This document contains side effect information about phenelzine. Some of the dosage forms listed on this page may not apply to the brand name Nardil.
For the ConsumerApplies to phenelzine: oral tablet
Oral route (Tablet)
Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder (MDD) and other psychiatric disorders. Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Not approved for use in pediatric patients.
Along with its needed effects, phenelzine (the active ingredient contained in Nardil) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking phenelzine:
More common
Less common
Some side effects of phenelzine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Less common
For Healthcare Professionals
Applies to phenelzine: oral tablet
GeneralThe most important adverse event reported is hypertensive crisis, which has been associated with intracranial bleeding and has been fatal.
Nervous systemCommon (1% to 10%): Dizziness, drowsiness, headache, hyperreflexia, myoclonic movements, tremors
Uncommon (0.1% to 1%): Convulsions, palilalia, paresthesia, peripheral neuritis
Rare (0.01% to 0.1%): Acute dystonic reaction, ataxia, coma, neuroleptic malignant syndrome (occasionally fatal), sensorimotor peripheral neuropathy, shock-like coma, speech blockade, transient respiratory and cardiovascular depression following ECT
Frequency not reported: Intracranial bleeding/fatal intracranial bleeding, occipital headache/occipital headache which may radiate frontally
PsychiatricCommon (1% to 10%): Anorgasmia, hypersomnia, hypomania, insomnia, sleep disturbances
Uncommon (0.1% to 1%): Agitation, behavioral changes, confusion, euphoria, frank psychosis, hallucinations, nervousness, vivid nightmares
Rare (0.01% to 0.1%): Acute anxiety reaction, delusional parasitosis, manic reaction, precipitation of schizophrenia, toxic delirium
Frequency not reported: suicidal behaviors, suicidal ideation
GastrointestinalCommon (1% to 10%): Constipation, dry mouth, gastrointestinal disturbances, nausea, vomiting
GenitourinaryCommon (1% to 10%): Anorgasmia, ejaculatory disturbances, impotence, sexual disturbances
Uncommon (0.1% to 1%): Delayed ejaculation, difficulty in micturition, urinary retention
OtherCommon (1% to 10%): Adverse effects on driving ability, fatigue, weakness
Uncommon (0.1% to 1%): Jitteriness, withdrawal/withdrawal syndrome
Rare (less than 0.1%): Fever associated with increased muscle tone, hyperpyrexia, malaise
Withdrawal may be associated with nausea, vomiting, and malaise.
Withdrawal syndrome occurred after abrupt drug discontinuation, and generally started after 24 to 72 hours; signs/symptoms varied from vivid nightmares and agitation to frank psychosis and convulsions. The withdrawal syndrome generally responded to reinstitution of low dose therapy, followed by cautious downward titration and discontinuation.
CardiovascularCommon (1% to 10%): Edema, postural hypotension
Uncommon (0.1% to 1%): Arrhythmias
Rare (0.01% to 0.1%): Blood pressure changes, tachycardia
Frequency not reported: Bradycardia, constricting chest pain, hypertensive crisis, palpitation
MetabolicHyponatremia may be more likely to occur in older patients or in those with inappropriate secretion of antidiuretic hormone; this side effect should be considered in patients treated with antidepressants who present with confusion, convulsions, and/or drowsiness.
Hypermetabolic syndrome may resemble signs/symptoms of an overdose.
Common (1% to 10%): Weight gain
Uncommon (0.1% to 1%): Hypernatremia, increased appetite
Rare (0.01% to 0.1%): Hypermetabolic syndrome, metabolic acidosis
Frequency not reported: Hyponatremia
OcularCommon (1% to 10%): Blurred vision
Uncommon (0.1% to 1%): Glaucoma, nystagmus
Frequency not reported: Dilated pupils, photophobia
MusculoskeletalCommon (1% to 10%): Twitching
Uncommon (0.1% to 1%): Muscle tremor
Rare (0.01% to 0.1%): Elevated creatine kinase levels, muscular rigidity
Frequency not reported: Neck soreness, neck stiffness
HepaticCommon (1% to 10%): Elevated serum transaminases (without accompanying signs/symptoms)
Uncommon (0.1% to 1%): Elevated liver enzymes
Rare (less than 0.1%): Fatal progressive necrotizing hepatocellular damage, reversible jaundice
DermatologicUncommon (0.1% to 1%): Pruritus, purpura, rash/skin rash, sweating
Frequency not reported: Sweating with cold, clammy skin or fever
HematologicUncommon (0.1% to 1%): Blood dyscrasias
Rare (less than 0.1%): Leucopenia
ImmunologicUncommon (0.1% to 1%): Lupus-like illness
RespiratoryRare (0.01% to 0.1%): Hypoxia, tachypnea
HypersensitivityRare (0.01% to 0.1%): Edema of the glottis
EndocrineRare (0.01% to 0.1%): Inappropriate secretion of antidiuretic hormone/ADH secretion
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/27/2021.
Source: Drugs.com Nardil (www.drugs.com/mtm/nardil.html).
March 19, 2021
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