When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to phenelzine, or if you have high blood pressure, liver disease, heart failure, severe kidney disease, or pheochromocytoma (a tumor of the adrenal gland).

How to Use This Medicine:
Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you. You may need to use this medicine for up to 4 weeks before you start to feel better.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• You must avoid many other medicines while you are using phenelzine. These medicines used together could cause serious health problems, including death. Ask your doctor before you use any other medicine. You may need to wait 1 to 5 weeks before you can use the other medicine.
• Do not use phenelzine if you have used another MAOI within the past 14 days. Do not use this medicine if you are also using meperidine, dextromethorphan, methylphenidate, dopamine, epinephrine, methyldopa, bupropion, buspirone, tryptophan, guanethidine, narcotic medicine, or medicine to treat depression (such as an SSRI or SSNRI). This is not a complete list.
• Avoid foods and drinks that are high in tyramine, because your blood pressure could get dangerously high. Your doctor should give you a complete list. In general, do not eat anything aged or fermented, such as most cheese, most alcohol, cured meat (such as salami), sauerkraut, and soy sauce. Check the expiration dates on packages. Tyramine levels get higher as food gets older or if it has not been refrigerated properly.
• Some other medicines that might interact with phenelzine include carbamazepine, cyclobenzaprine, blood pressure medicine, cough and cold medicine, TCA medicine to treat depression, and diuretics (water pills). This is not a complete list.
• Do not drink alcohol while you are using this medicine. Limit how much caffeine you drink or eat.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, diabetes, epilepsy, or schizophrenia.
• For some children, teenagers, and young adults, this medicine may increase mental or emotional problems. This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or anyone in your family has a history of bipolar disorder or suicide attempts.
• This medicine may cause extremely high blood pressure, which could be life-threatening.
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you feel lightheaded.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests. Also, this medicine may interact with the dye used during some medical tests.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Feeling more excited or energetic than usual, trouble sleeping
• Frequent or severe headache, fast or pounding heartbeat
• Lightheadedness, dizziness, or fainting
• Stiff neck, nausea, vomiting, sweating, light sensitivity
• Unusual behavior, thoughts of hurting yourself or others

If you notice these less serious side effects, talk with your doctor:

• Dry mouth
• Mild diarrhea, constipation, or stomach pain

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088