II. Precautions

  1. See MAO Inhibitors
  2. Follow low tyramine diet and avoid Sympathomimetics, Serotonergic Medications
  3. MAO Inhibitors are not first-line agents for Mood Disorders

III. Indications

  1. Refractory Major Depression

IV. Dosing

  1. Start: 15 mg orally three times daily
  2. Target dose: 60-90 mg/day divided two to three times daily
  3. Maximum: 90 mg/day
  4. Titrate back down to lowest effective dose as able

V. Mechanism

  1. See MAO Inhibitor
  2. Phenelzine is a hydrazine MAO Inhibitor which irreversibly blocks MAO nonselectively (MAO-A and MAO-B are both affected)

VI. Safety

  1. Unknown safety in pregnancy and Lactation

VII. Adverse Effects

VIII. Drug Interactions

  1. See MAO Inhibitors
  2. Hepatic metabolism

X. References

  1. (2023) Med Lett Drugs Ther 62(1592): 25-32
  2. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 36-7
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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Cost: Medications

phenelzine (on 9/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
PHENELZINE SULFATE 15 MG TAB Generic $0.57 each

Ontology: Phenelzine (C0031392)

Definition (MSH) One of the MONOAMINE OXIDASE INHIBITORS used to treat DEPRESSION; PHOBIC DISORDERS; and PANIC.
Definition (CSP) monoamine oxidase inhibitor used to treat depression and phobic disorders.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D010624
SnomedCT 387528000, 9500005
LNC LP17998-3, MTHU024864
English 2 Phenethylhydrazine, 2-Phenethylhydrazine, Fenelzin, Phenelzine, Phenethylhydrazine, beta Phenylethylhydrazine, beta-Phenylethylhydrazine, phenelzine, Hydrazine, (2-phenylethyl)-, Phenelzine [Chemical/Ingredient], fenelzin, PHENELZINE, MAOI - Phenelzine, Phenelzine (product), Phenelzine (substance)
Swedish Fenelzin
Czech fenelzin
Finnish Feneltsiini
Russian FENELZIN, ФЕНЕЛЗИН
Japanese フェネルジン
Italian beta-Feniletilidrazina, Fenelzina
Spanish fenelcina, fenelzina (producto), fenelcina (producto), fenelcina (sustancia), fenelzina (sustancia), fenelzina, Fenelzina, Fenelzin
Polish Nardil, Fenelzyna
French Phénelzine
German Fenelzin, Phenelzin
Portuguese Fenelzina

Ontology: Nardil (C0701388)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D010624
English nardil, Nardil, Parke Davis Brand of Phenelzine Sulfate, Pfizer Brand of Phenelzine Sulfate, United Drug Brand of Phenelzine Sulfate