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Precautions and Warnings With Phenelzine

Specific Precautions and Warnings With Phenelzine

Warnings and precautions to be aware of prior to taking phenelzine include the following:
  • Phenelzine should be used only after other treatments have failed. Anyone taking the medication should do so under close supervision of their healthcare provider.
  • Many foods and drugs can cause potentially lethal interactions when combined with phenelzine. In order to take phenelzine safely, you must commit to avoiding many foods and medications, including many non-prescription medications. Always check with your healthcare provider before taking any medications (see Drug Interactions With Phenelzine and Nardil Food Interactions for more information).
  • Phenelzine can cause hypertensive crisis, which is a life-threatening increase in blood pressure. Tell your healthcare provider right away if you have symptoms of a hypertensive crisis, such as:
    • Headaches
    • Feelings of a rapidly or forcefully beating heart (palpitations)
    • Sore or stiff neck
    • Nausea or vomiting
    • Sweating, with a high fever (or sometimes with cold, clammy skin)
    • Sensitivity to light
    • Rapid heart rate (tachycardia) or low heart rate (bradycardia)
    • Chest pain or throat tightness
    • Dilated (wide open) pupils.
  • Antidepressants (including phenelzine) may increase the risk of suicidal thinking or behavior (see Depression and Suicide). Therefore, if you notice any changes in symptoms or new symptoms, talk to your healthcare provider immediately. Some of these symptoms may include:
    • Anxiety
    • Hostility
    • Agitation
    • Panic
    • Restlessness
    • Hallucinations
    • Extreme hyperactivity
  • Phenelzine may make schizophrenia worse. If you have schizophrenia, talk with your healthcare provider before taking the medication.
  • Before prescribing phenelzine for depression, your healthcare provider should make sure that you do not have bipolar disorder instead. Sometimes, the symptoms of bipolar disorder and depression can be similar, and phenelzine can cause problems in people with bipolar disorder.
  • Be sure to tell all your healthcare providers (including dentists and surgeons) that you are taking phenelzine.
  • The medication should be used cautiously in people with diabetes, as it may make these people more sensitive to insulin. Your healthcare provider may recommend monitoring your blood sugar more closely or adjusting your dose of diabetes medication.
  • In addition to causing dangerously high blood pressure, phenelzine can cause low blood pressure (hypotension). Let your healthcare provider known if you have symptoms of low blood pressure, such as lightheadedness, dizziness, or fainting.
  • People taking the drug should use caution when driving, operating heavy machinery, or performing other tasks that require concentration, especially when first starting phenelzine or when switching dosages. This is because the medication may affect a person's mental or physical ability to perform these tasks. Make sure that you know how the drug affects you before performing any tasks that require mental or physical concentration.
  • Phenelzine may not be safe for use during pregnancy. Discuss the benefits and risk of using the drug while pregnant with your healthcare provider (see Nardil and Pregnancy).
  • It is not known if phenelzine passes through breast milk. Therefore, if you are breastfeeding or plan to start, talk with your healthcare provider about what makes most sense for your particular situation (see Nardil and Breastfeeding).
  • Special care should be used when taking phenelzine if you have a history of seizures, as the medication can make seizures worse.
  • Elderly people appear to be more sensitive to phenelzine, and certain side effects of phenelzine may be more dangerous in elderly people.
  • The medication can cause low blood sugar (hypoglycemia) in people taking diabetes medications. When starting phenelzine or changing dosages, make sure to check your blood sugar levels more often.
  • Do not stop taking phenelzine without first discussing it with your healthcare provider. Stopping the medicine abruptly may increase the risk for withdrawal symptoms (see Nardil Withdrawal).
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