Marplan

— THERAPEUTIC CATEGORIES —
  • Mood disorders

Marplan Generic Name & Formulations

General Description

Isocarboxazid 10mg; scored tabs.

Pharmacological Class

MAOI.

How Supplied

Tabs—100

Marplan Indications

Indications

Refractory depression.

Marplan Dosage and Administration

Adult

Initially 10mg twice daily. May increase by 10mg every 2–4 days up to 40mg daily. If tolerated, may increase by 20mg/week to max 60mg/day divided into 2–4 doses.

Children

<16yrs: not recommended.

Marplan Contraindications

Contraindications

See Interactions. Pheochromocytoma. Cardiovascular, cerebrovascular, or liver disease. Hypertension. Chronic headache. To avoid potentially severe or fatal interactions, allow sufficient drug-free interval (see full labeling) between isocarboxazid and sympathomimetics (eg, amphetamines, pseudoephedrine), tricyclic antidepressants (eg, amitriptyline, clomipramine), SSRIs or other neurotransmitter reuptake inhibitors (eg, fluoxetine), maprotiline, CNS depressants (eg, alcohol, barbiturates, narcotics), antihistamines, antihypertensives (eg, guanethidine), anesthetics, bupropion, buspirone, carbamazepine, cyclobenzaprine, dibenzazepines, diuretics, dextromethorphan, dopamine, other MAOIs (eg, phenelzine, selegiline, furazolidone, tranylcypromine), levodopa, methyldopa, methylphenidate, phenylalanine, tryptophan-, dopamine-, tyrosine-, or tyramine-containing foods, excess caffeine or chocolate. Meperidine within 3 weeks of isocarboxazid.

Marplan Boxed Warnings

Boxed Warning

Suicidality and antidepressant drugs.

Marplan Warnings/Precautions

Warnings/Precautions

Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor all patients for clinical worsening or unusual behavioral changes. Screen for risk of bipolar disorder prior to initiation. Mania/hypomania. Psychosis. Epilepsy. Hyperthyroidism. Surgery. Schizophrenia. Discontinue if palpitations or headache occurs, 48hrs before to 24hrs after myelography, or at 1st sign of jaundice or hepatic dysfunction. Avoid abrupt cessation. Hypotension. Monitor BP and observe patient frequently. May mask anginal pain or aggravate anxiety or agitation. Renal impairment. Elderly. Debilitated. Pregnancy. Nursing mothers.

Marplan Pharmacokinetics

See Literature

Marplan Interactions

Interactions

See Contraindications. Hypertensive crises with sympathomimetics, levodopa, and high-tyramine foods (eg, cheese, salami, chocolate, wine, beer, pickled herring, chicken livers, yeast extract, yogurt, broad beans). Caution with antidiabetic agents, antiparkinson agents, disulfiram. Potentiates CNS depressants, antihypertensives. Psychosis with dextromethorphan. Circulatory collapse, coma, death with meperidine. Do not start within 5wks of fluoxetine, 10 days of buspirone, or 2wks of sertraline, paroxetine, bupropion or citalopram, or 1wk of venlafaxine discontinuance.

Marplan Adverse Reactions

Adverse Reactions

Orthostatic hypotension, hypertensive crises, dizziness, headache, dry mouth, GI disturbances, blurred vision, akathisia, ataxia, black tongue, coma, dysuria, euphoria, hematologic changes, incontinence, photosensitivity, seizures, changes in blood sugar.

Marplan Clinical Trials

See Literature

Marplan Note

Notes

To enroll pregnant patients exposed to Marplan in the National Pregnancy Registry for Antidepressants, call (844) 405-6185.

Marplan Patient Counseling

See Literature