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