Phenelzine

CLINICAL USE

MAOI antidepressant

DOSE IN NORMAL RENAL FUNCTION

15 mg 3 times daily; maximum: 30 mg 3 times daily

PHARMACOKINETICS

Molecular weight :136 (234.3 as sulphate)

%Protein binding :No data

%Excreted unchanged in urine : 0.25–1.1

Volume of distribution (L/kg) :No data

half-life – normal/ESRD (hrs) :1.2/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

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

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

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See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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