Posted by Jedi on September 7, 2005, at 11:31:43
In reply to Nardil - Question on washout period and Zyprexa, posted by denise1966 on September 7, 2005, at 9:35:47
> I was just wondering if it's really imperative to have a two week washout period after taking Nardil, wouldn't one suffice?
Hi Denise,
The washout period for Nardil varies depending on the medication that you are taking next. Most serotoninergic medications can be taken after a 10-day washout. Following is an excerpt from Pfizer’s US prescribing information on Nardil. Some of the medications that are contraindicated with Nardil (bupropion SR) I have taken simultaneously with Nardil. I’m not telling others to do this.
Take care,
JediUS Prescribing information for phenelzine:
http://www.pfizer.com/pfizer/download/uspi_nardil.pdfCONTRAINDICATIONS
NARDIL should not be used in patients who are hypersensitive to the drug or its
ingredients, with pheochromocytoma, congestive heart failure, a history of liver disease,
or abnormal liver function tests.
The potentiation of sympathomimetic substances and related compounds by MAO
inhibitors may result in hypertensive crises. Therefore, patients being
treated with NARDIL should not take sympathomimetic drugs (including amphetamines,
cocaine, methylphenidate, dopamine, epinephrine, and norepinephrine) or related
compounds (including methyldopa, L-dopa, L-tryptophan, L-tyrosine, and
phenylalanine). Hypertensive crises during NARDIL therapy may also be caused by the
ingestion of foods with a high concentration of tyramine or dopamine.NARDIL should not be used in combination with dextromethorphan or with CNS
depressants such as alcohol and certain narcotics. Excitation, seizures, delirium,
hyperpyrexia, circulatory collapse, coma, and death have been reported in patients
receiving MAOI therapy who have been given a single dose of meperidine. NARDIL
should not be administered together with or in rapid succession to other MAO inhibitors
because HYPERTENSIVE CRISES and convulsive seizures, fever, marked sweating,
excitation, delirium, tremor, coma, and circulatory collapse may occur.NARDIL should also not be used in combination with buspirone HCl, since several cases
of elevated blood pressure have been reported in patients taking MAO inhibitors who
were then given buspirone HCl. At least 10 days should elapse between the
discontinuation of NARDIL and the institution of another antidepressant or buspirone
HCl, or the discontinuation of another MAO inhibitor and the institution of NARDIL.
There have been reports of serious reactions (including hyperthermia, rigidity, myoclonic
movements and death) when serotoninergic drugs (e.g., dexfenfluramine, fluoxetine,
fluvoxamine, paroxetine, sertraline, citalopram, venlafaxine) have been combined with a
MAO inhibitor. Therefore, the concomitant use of NARDIL with serotoninergic agents is
contraindicated (see PRECAUTIONS-Drug Interactions). Allow at least five weeks
between discontinuation of fluoxetine and initiation of NARDIL and at least 10 days
between discontinuation of NARDIL and initiation of fluoxetine, or other serotoninergic
agents. Before initiating NARDIL after using other serotoninergic agents, a sufficient
amount of time must be allowed for clearance of the serotoninergic agent and its active
metabolites.
The combination of MAO inhibitors and tryptophan has been reported to cause
behavioral and neurologic syndromes including disorientation, confusion, amnesia,
delirium, agitation, hypomanic signs, ataxia, myoclonus, hyperreflexia, shivering, ocular
oscillations, and Babinski signs.
The concurrent administration of an MAO inhibitor and bupropion hydrochloride
(Wellbutrin®) is contraindicated. At least 14 days should elapse between discontinuation
of an MAO inhibitor and initiation of treatment with bupropion hydrochloride.
Patients taking NARDIL should not undergo elective surgery requiring general
anesthesia. Also, they should not be given cocaine or local anesthesia containing
sympathomimetic vasoconstrictors. The possible combined hypotensive effects of
NARDIL and spinal anesthesia should be kept in mind. NARDIL should be discontinued
at least 10 days prior to elective surgery.MAO inhibitors, including NARDIL, are contraindicated in patients receiving
guanethidine.
poster:Jedi
thread:551847
URL: http://www.dr-bob.org/babble/20050901/msgs/551874.html