Antidepressants, Monoamine Oxidase (MAO) Inhibitor (Systemic)

Precautions While Using This Medicine

When taken with certain foods, drinks, or other medicines, MAO inhibitors can cause very dangerous reactions such as sudden high blood pressure (also called hypertensive crisis). To avoid such reactions, obey the following rules of caution :

• Do not eat foods that have a high tyramine content (most common in foods that are aged or fermented to increase their flavor), such as cheeses; fava or broad bean pods; yeast or meat extracts; smoked or pickled meat, poultry, or fish; fermented sausage (bologna, pepperoni, salami, and summer sausage) or other fermented meat; sauerkraut; or any overripe fruit. If a list of these foods is not given to you, ask your health care professional to provide one.
• Do not drink alcoholic beverages or alcohol-free or reduced-alcohol beer and wine.
• Do not eat or drink large amounts of caffeine-containing food or beverages such as coffee, tea, cola, or chocolate.
• Do not take any other medicine unless approved or prescribed by your doctor. This especially includes nonprescription (over-the-counter [OTC]) medicine, such as that for colds (including nose drops or sprays), cough, asthma, hay fever, and appetite control; �keep awake'" products; or products that make you sleepy.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine .

Check with your doctor or hospital emergency room immediately if severe headache, stiff neck, chest pains, fast heartbeat, or nausea and vomiting occur while you are taking this medicine. These may be symptoms of a serious side effect that should have a doctor's attention.

Do not stop taking this medicine without first checking with your doctor . Your doctor may want you to reduce gradually the amount you are using before stopping completely.

Dizziness, lightheadedness, or fainting may occur , especially when you get up from a lying or sitting position. Getting up slowly may help . When you get up from lying down, sit on the edge of the bed with your feet dangling for 1 or 2 minutes. Then stand up slowly. If the problem continues or gets worse, check with your doctor.

This medicine may cause blurred vision or make some people drowsy or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are unable to see well or are not alert .

Before having any kind of surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are using this medicine or have used it within the past 2 weeks . Taking MAO inhibitors together with medicines that are used during surgery or dental or emergency treatments may increase the risk of serious side effects.

Your doctor may want you to carry an identification card stating that you are using this medicine.

For patients with angina (chest pain):

• This medicine may cause you to have an unusual feeling of good health and energy. However, do not suddenly increase the amount of exercise you get without discussing it with your doctor . Too much activity could bring on an attack of angina.

For diabetic patients:

• This medicine may affect blood sugar levels. While you are using this medicine, be especially careful in testing for sugar in your blood or urine. If you have any questions about this, check with your doctor.

After you stop using this medicine, you must continue to obey the rules of caution for at least 2 weeks concerning food, drink, and other medicine, since these things may continue to react with MAO inhibitors.