Marplan is a monoamine oxidase inhibitor (MAOI) that works by increasing the levels of certain chemicals in the brain.

Marplan is used to treat symptoms of depression that may include anxiety, panic, or phobias. This medicine is usually given after other antidepressants have been tried without successful treatment of symptoms.

Marplan may also be used for purposes not listed in this medication guide.

There are many other medicines that can cause serious medical problems or death if you take them together with Marplan. Before taking this medicine, tell your doctor about all medicines you have used within the past 5 weeks.

Do not use Marplan if you have used another MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include linezolid, methylene blue injection, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine, and others.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using Marplan. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

While you are taking Marplan, you must not drink alcohol or eat foods that are high in tyramine, listed in the "What should I avoid while taking this medicine?" section of this leaflet. Eating tyramine while you are taking this medicine can raise your blood pressure to dangerous levels.

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Your blood pressure will need to be tested often. You may also need frequent blood tests to check your liver function.

It may take up to 6 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

If you need surgery, tell the surgeon ahead of time that you are using Marplan. You may need to stop using the medicine for at least 10 days before surgery.

Store at room temperature away from moisture and heat.

You should not take Marplan if you are allergic to it, or if you have:

• pheochromocytoma (tumor of the adrenal gland);

• liver disease;

• kidney disease;

• a history of stroke or blood clots;

• heart disease, high blood pressure; or

• a history of severe or frequent headaches.

There are many other medicines that can cause serious medical problems or death if you take them together with Marplan.

Before taking Marplan, tell your doctor about all medicines you have used within the past 5 weeks. The following drugs should not be used while you are taking this medicine:

• buspirone (Buspar);

• carbamazepine;

• levodopa;

• methyldopa;

• tryptophan;

• certain antidepressants--amitriptylline, bupropion, citalopram, clomipramine, desipramine, doxepin, escitalopram, fluoxetine, fluvoxamine, imipramine, maprotiline, nortriptyline, paroxetine, protriptyline, sertraline, trimipramine (known by brand names such as Celexa, Lexapro, Luvox, Norpramin, Prozac, Paxil, Wellbutrin, and Zoloft);

• narcotic pain medicine--morphine, tramadol, Demerol, OxyContin, Percocet, Vicodin, and others;

• ADHD medicine--Adderall, Concerta, Ritalin, Vyvanse, and others;

• diet pills; or

• over-the-counter cough or cold medicine.

Do not use Marplan if you have used another MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include linezolid, methylene blue injection, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine, and others.

To make sure Marplan is safe for you, tell your doctor if you have:

• a history of heart disease or high blood pressure;

• diabetes;

• a thyroid disorder;

• schizophrenia;

• epilepsy or other seizure disorder; or

• if you have taken any other antidepressant within the past 5 weeks.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using Marplan. Your family or other caregivers should also be alert to changes in your mood or symptoms.

FDA pregnancy category C. It is not known whether Marplan will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using Marplan.

It is not known whether isocarboxazid passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give Marplan to anyone younger than 16 years old without the advice of a doctor.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include shallow breathing, fast heart rate, sweating, fever, slow reflexes, feeling light-headed, fainting, or seizure (convulsions).

Avoid coffee, tea, cola, energy drinks, or other products that contain caffeine.

While you are taking Marplan you must not drink alcohol or eat foods that are high in tyramine, including:

• cheese (especially strong or aged cheeses);

• sour cream and yogurt;

• beer (including non-alcoholic beer), sherry, Chianti wine, liqueurs;

• dry sausage (such as hard salami, pepperoni), anchovies, caviar, liver, pickled herring;

• canned figs, raisins, bananas;

• avocados;

• chocolate;

• soy sauce;

• sauerkraut;

• fava beans;

• yeast extracts;

• meat extracts; or

• meat prepared with tenderizer.

You should become very familiar with the list of foods and medicines you must avoid while you are taking Marplan. Eating tyramine while you are taking this medicine can raise your blood pressure to dangerous levels which could cause life-threatening side effects.

Marplan may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Stop taking Marplan and call your doctor at once if you have:

• sudden and severe headache, rapid heartbeat, stiffness in your neck, nausea, vomiting, cold sweat, vision problems, sensitivity to light;

• chest pain, fast or slow heart rate;

• swelling, rapid weight gain;

• jaundice (yellowing of the skin or eyes); or

• a light-headed feeling, like you might pass out.

Common side effects of Marplan may include:

• headache, dizziness, drowsiness;

• tremors;

• sleep problems (insomnia);

• constipation, nausea; or

• dry mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Taking Marplan with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking Marplan with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with Marplan, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with this medicine. Give a list of all your medicines to any healthcare provider who treats you.