20 to 50     : Dose as in normal renal function
10 to 20     : Dose as in normal renal function
<10           : Dose as in normal renal function
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Possibly dialysed. Dose as in normal renal function
HD                     :Possibly dialysed. Dose as in normal renal function
HDF/high flux   :Possibly dialysed. Dose as in normal renal function
CAV/VVHD      :Unknown dialysability. Dose as in normal renal function
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
Alcohol: some alcoholic and dealcoholised drinks contain tyramine which can cause hypertensive crisisAlpha-blockers: avoid concomitant use with indoramin; enhanced hypotensive effect
Anaesthetics: avoid concomitant use
Analgesics: CNS excitation or depression with pethidine, other opioids and nefopam – avoid concomitant use
Antidepressants: enhancement of CNS effects and toxicity. Care with all antidepressants including drug free periods when changing therapies
Anti-epileptics: antagonism of anticonvulsant effect; avoid carbamazepine with or within 2 weeks of MAOIs
Antimalarials: avoid concomitant use with artemether/lumefantrine
Antipsychotics: effects enhanced by clozapine
Atomoxetine: avoid concomitant use and for 2 weeks after useBupropion: avoid with or for 2 weeks after MAOIs
Dopaminergics: avoid concomitant use with entacapone and tolcapone; hypertensive crisis with levodopa and rasagiline – avoid for at least 2 weeks after stopping MAOI; hypotension with selegiline5HT 1 agonist: risk of CNS toxicity with sumatriptan, rizatriptan and zolmitriptan – avoid sumatriptan and rizatriptan for 2 weeks after MAOIMethyldopa: avoid concomitant use
Sibutramine: increased risk of CNS toxicity – avoid concomitant use
Sympathomimetics: hypertensive crisis with dexamfetamine, other amphetamines, dopamine, dopexamine, ephedrine, isometheptene, methylphenidate, phenylephrine, phenylpropanolamine, pseudoephedrine or sympathomimeticsTetrabenazine: risk of CNS excitation and hypertension