Patient Medication Information: uses, side effects, how to take - Parnate

Serious warnings and precautions box

What PARNATE is used for:

PARNATE is used for the treatment of major depressive disorder (MDD). It is only for use in adults who have not responded well to other antidepressants. PARNATE is not for the initial treatment of MDD.

How PARNATE works:

PARNATE belongs to the family of medicines called monoamine oxidase inhibitors (MAOIs). PARNATE helps with the symptoms of depression.

The ingredients in PARNATE are:

Medicinal ingredient(s): tranylcypromine sulfate.

Non-medicinal ingredients: carnauba wax, citric acid, croscarmellose sodium, D&C Red No. 7 (Lithol Rubin B Calcium Lake), FD&C Blue No. 2, FD&C Yellow No. 6 Aluminium Lake (Sunset Yellow), gelatin, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, purified water, talc, and titanium dioxide.

PARNATE comes in the following dosage form(s):

Tablets, 10 mg of tranylcypromine (as tranylcypromine sulfate).

Suicidal Thoughts and Behaviours: In studies, antidepressants were shown to increase the risk of suicidal thoughts and behaviours in young adults and patients under 18 years of age. Should this happen to you, or to those in your care if you are a caregiver or guardian, consult your healthcare professional immediately. You will need to be closely monitored by a healthcare professional during treatment with PARNATE.
Dangerous Increase in Blood Pressure: Certain foods and drinks must be avoided during treatment with PARNATE and for 2 weeks after stopping treatment. If you do not avoid certain foods and drinks, you may have a dangerous increase in blood pressure that can lead to death. A complete list of those foods and drinks are included in the section called “Foods and Beverages to avoid while taking PARNATE”.

Do not use PARNATE if:

you are allergic to tranylcypromine sulfate or to any other ingredients in PARNATE.
you or your healthcare professional thinks you have high blood pressure or heart disease.
you have ever had a stroke, or any other kind of disorder related to the brain and its blood vessels.
you have liver disease.
you have a blood disorder.
you have a history of severe or frequent headaches.
you have a tumour of the adrenal gland (pheochromocytoma) or a type of tumour called a paraganglioma.
you were recently or are taking any other medicine for depression or anxiety.
you were or are taking any of the following:
- carbamazepine, used to treat seizures.
- cyclobenzaprine, used as a muscle relaxant.
- sumatriptan, rizatriptan and other triptans, used to treat migraines and cluster headaches.
- non-prescription medications to treat colds or hay fever, including drops or sprays.
- natural health products that are for increased energy or weight loss.
- street drugs including MDMA and ecstasy.
- amphetamines, used to treat attention deficit disorder.
- products containing ephedrine, used to treat nasal congestion.
- methyldopa, used to treat high blood pressure.
- dopamine, used in hospital to treat certain medical emergencies.
- levodopa, used to treat Parkinson’s disease.
- dextromethorphan, used as a cough suppressant.
- meperidine, tapentadol, and tramadol, used to manage pain.

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take PARNATE. Talk about any health conditions or problems you may have, including if you:

have a history of kidney or heart problems.
have diabetes.
have epilepsy.
have an overactive thyroid gland.
have mania or bipolar disorder.
have or have ever had recurrent or frequent headaches.
are pregnant or plan to become pregnant.
are breastfeeding or plan to breastfeed.
are 60 years of age or older.
drink alcohol and/or use street drugs.
recently had a surgery or are planning to have surgery.
have ever had a seizure or have risk of having a seizure.
have any of the following rare genetic conditions:
- galactose intolerance,
- Lapp lactase deficiency,
- glucose-galactose malabsorption.

Lactose is a non-medicinal ingredient in PARNATE.

Other warnings you should know about:

Eye tests: PARNATE can cause glaucoma (increased pressure in the eyes). Your healthcare professional may ask you to have your eyes examined to ensure if you are at risk of developing glaucoma.

Driving and using machines: PARNATE can cause dizziness and drowsiness. Before you drive or do tasks that require special attention, wait until you know how you respond to PARNATE. If you have any of these effects, you should not drive or do tasks that require special attention or coordination.

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.

Serious drug interactions:

Serious drug interactions with PARNATE include:

food and drinks that contain a high amounts of tyramine (see the “Foods and beverages to avoid while taking PARNATE” section below).
antidepressants, used to treat depression such as:
- other monoamine oxidase inhibitors (MAOIs) (e.g., phenelzine sulphate, isocarboxazid, nialamide, and pargyline).
- selective serotonin reuptake inhibitors (SSRIs) or serotonin and noradrenaline reuptake inhibitors (SNRIs) (e.g., venlafaxine).
- tricyclic antidepressants (e.g., amitriptyline, nortriptyline, protriptyline, desipramine, imipramine, doxepin, perphenazine, amoxapine, trimipramine, and clomipramine hydrochloride).
- others (e.g., bupropion, maprotiline, nefazodone, trazodone, vilazodone, s-adenosyl-L-methionine (SAM-e), and vortioxetine).
serotonin releasing agents, used to treat attention deficit/hyperactivity disorder (ADHD) and sleeping problems (e.g., amphetamine and methylphenidate).
triptans, used to treat migraines (e.g., sumatriptan or rizatriptan).
sympathomimetics, used to treat various conditions such as heart attacks, breathing problems, and low blood pressure (e.g., pseudoephedrine, phenylephedine, ephedrine, and dopamine).
meperidine, tapentadol, and tramadol, used to treat pain.
dextromethorphan, used to reduce coughing.
buspirone hydrochloride, used to treat anxiety.
carbamazepine, used to treat epilepsy (seizures).
cyclobenzaprine, used to treat muscle spasms.
milnacipran, used to treat fibromyalgia (chronic muscle pain and stiffness).
rasagiline and levodopa, used to treat Parkinson’s disease
tetrabenazine, used to a movement disorder called chorea.
methyldopa and reserpine, used to treat high blood pressure.
tryptophan and hydroxytryptophan, used to help the body make serotonin and melatonin.

The following may also interact with PARNATE:

CNS depressants, used to slow down brain activity and the nervous system (e.g., barbiturates).
opioids, used to manage pain (e.g., fentanyl, buprenorphine, and methadone).
hypotensive agents, used to lower blood pressure (e.g., guanethidine).
phenothiazine drugs, used to treat certain mental health conditions (e.g., trifluoperazine, chlorpromazine).
antiparkinsonian drugs, used to treat Parkinson’s disease.
disulfiram, used to treat alcohol use disorder.
blood glucose-lowering agents, used to lower blood sugar levels (e.g., insulin).
St. John’s Wort, a natural health product used to treat depression

Ask your healthcare professional if you are unsure.

Foods and beverages to avoid while taking PARNATE:

A process of aging or breakdown is used to improve the flavor certain foods. It is important to avoid foods that contain high amounts of tyramine while you are taking PARNATE. Tyramine can interact with PARNATE to cause dangerously high blood pressure. It is very important that you buy and eat only fresh foods or those that have been properly frozen. Fresh foods can age naturally over time, so make sure to eat them when they are fresh.

The table below lists foods to avoid while taking PARNATE and for 2 weeks after stopping it. There are also suggestions of acceptable foods and drinks to help guide you.

Class of Food or Beverage	Tyramine-Rich Foods and Beverages to Avoid	Acceptable Foods and Drinks, Containing No or Little Tyramine
Meat, Poultry, and Fish	Air dried, aged and fermented meats, sausages and salamis (including cacciatore, hard salami and mortadella); pickled herring; and any spoiled or improperly stored meat, poultry, and fish (e.g., foods that have undergone changes in coloration, odor, or become moldy); spoiled or improperly stored animal livers	Fresh meat, poultry, and fish, including fresh processed meats (e.g., lunch meats, hot dogs, breakfast sausage, and cooked sliced ham)
Vegetables	Broad bean pods (fava bean pods)	All other vegetables
Dairy	Aged cheeses	Processed cheeses, mozzarella, ricotta cheese, cottage cheese, and yogurt
Beverages	All varieties of tap beer and beers that have not been pasteurized so as to allow for ongoing fermentation and excessive amounts of caffeine.	Use of alcohol with PARNATE is not recommended. (Bottled and canned beers and wines contain little or no tyramine.)
Other	Concentrated yeast extract (e.g., Marmite), sauerkraut, most soybean products (including soy sauce and tofu),	Brewer’s yeast, baker’s yeast, soy milk, commercial chain restaurant pizzas prepared with cheeses low in tyramine

non-prescription drugs and natural health products containing tyramine, and chocolate

Check the ingredients of foods or drinks that you have not prepared yourself, including pre-prepared foods and restaurant foods. Speak with your healthcare professional if you have any questions.

How to take PARNATE:

Take the tablets in the morning and again mid-afternoon. Since PARNATE may cause sleeping problems, you should try to take your mid-afternoon dose no later than 3 pm. It is better if you take your tablets at the same time every day.
You should continue to take your medicine even if you do not feel better, as it may take a few weeks for PARNATE to work. When you start taking PARNATE or when your dose changes, you may feel worse instead of better. This may include unusual feelings of agitation, hostility, anxiety, or have impulsive or disturbing thoughts (e.g., thoughts of self-harm or harm to others). Should this happen to you, consult your healthcare professional right away.
It is important that you take PARNATE exactly as your healthcare professional has instructed. Do NOT stop taking your medication on your own. Your healthcare professional will guide you about how to stop taking PARNATE slowly to help avoid side effects.

Usual dose:

The usual starting dose of PARNATE is one 10 mg tablet taken 2 times a day (morning and afternoon).

Remember: This medicine has been prescribed only for you. Do not give it to anybody else, as they may experience undesirable effects, which may be serious.

Overdose:

If you think you, or a person you are caring for, have taken too much PARNATE, contact a healthcare professional, hospital emergency department, regional poison control centre, or Health Canada’s toll-free number, 1-844 POISON-X (1-844-764-7669) immediately, even if there are no signs or symptoms.

Missed dose:

If you missed a dose of this medication, you do not need to make up the missed dose. Skip the missed dose and continue with your next scheduled dose. Do not take two doses at the same time.

Possible side effects from using PARNATE:

These are not all the possible side effects you may have when taking PARNATE. If you experience any side effects not listed here, tell your healthcare professional.

Possible side effects of PARNATE include the following:

trouble sleeping;
feeling sick (nausea);
dry mouth;
feeling tired or sleepy;
weakness;
dizziness;
loss of appetite;
diarrhea;
constipation;
headache;
muscle spasms, twitches or shakiness;
restlessness;
tingling or prickling feeling;
ringing or buzzing in the ears;
abdominal pain;
swelling;
chills;
uncontrolled eye movement;
difficulty moving;
loss of coordination or balance;
muscle twitch or jerks;
altered sense of taste;
cracks at the corners of the mouth.

Serious side effects and what to do about them

Frequency/Side Effect/Symptom	Talk to your healthcare professional	Stop taking this drug and get immediate medical help
Only if severe	In all cases
Rare
Allergic reactions: including but not limited to red and lumpy skin rash, hives, swelling in the mouth, tongue, face and throat, itching, rash, trouble breathing		✓
Very rare
Unusual hair loss or thinning		✓
Unknown
Agranulocytosis and leukopenia (low white blood cells such as neutrophils, and leukocytes): fever or infection, fatigue, aches and pains, and flu-like symptoms		✓
Anemia (low red blood cells): being short of breath, feeling very tired, having pale skin, fast heartbeat, loss of energy, or weakness		✓
Blood pressure changes (usually low or high blood pressure): severe dizziness or fainting on standing		✓
Drug dependence and discontinuation symptoms: withdrawal symptoms may include sleep disturbances, depression, confusion, delirium,		✓

Frequency/Side Effect/Symptom	Talk to your healthcare professional	Stop taking this drug and get immediate medical help
Only if severe	In all cases
tremor, agitation, convulsion, anxiety, nervousness, hallucinations, headache
Glaucoma (increased pressure in the eyes): blurred vision, eye pain, changes in vision, swelling or redness in or around the eye		✓
Hepatitis (inflammation of the liver): yellow discoloration of the skin and whites of the eyes, dark urine, vomiting, and abdominal pain		✓
Hypertensive crisis (dangerous increase in blood pressure): severe or frequent headaches, chest pain, fast or slow heartbeat, neck stiffness or soreness, sweating with initial paleness followed by flushing of the skin, enlarged pupils, nausea, vomiting and unusual bleeding or bruising			✓
New or worsened emotional or behavioural problems: unusual feelings of agitation, hostility or anxiety, impulsive or disturbing thoughts such as thoughts of self-harm or harm to others		✓
Overstimulation: symptoms may include feeling excessive happiness or irritability, agitation, anxiety, greatly increased energy, racing thoughts, talking more or faster than usual, reckless behaviour		✓
Thrombocytopenia (low blood platelets): bruising or bleeding for longer than usual if you hurt yourself, fatigue and weakness		✓
Urinary retention: difficulty passing urine		✓

If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.

Reporting side effects

You can report any suspected side effects associated with the use of health products to Health Canada by:

Visiting the Web page on Adverse Reaction Reporting (canada.ca/drug-device-reporting) for information on how to report online, by mail or by fax; or
Calling toll-free at 1-866-234-2345.

NOTE: Contact your healthcare professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice.

Storage:

Store PARNATE between 15°C and 30°C.

Keep out of reach and sight of children.

If you want more information about PARNATE:

Talk to your healthcare professional.
Find the full Product Monograph that is prepared for healthcare professionals and includes the Patient Medication Information by visiting the Health Canada Drug Product Database website (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html); the manufacturer’s website (www.gsk.ca); or by calling 1-800-387-7374.

Date of Authorization: 2026-09-29

Trademarks are owned by or licensed to the GSK group of companies

Rx or OTC	Prescription (Rx)?
DIN	01919598
Schedule(s)	PRESCRIPTION
Active ingredient(s)	Tranylcypromine (tranylcypromine sulfate) 10 MG
Dosage form(s)	Tablet
Route(s) of administration	Oral
Drug class (WHO ATC)	N Nervous system drugs N06 Psychoanaleptics N06A Antidepressants N06AF Monoamine oxidase inhibitors, non-selective N06AF04 Tranylcypromine
Company	GLAXOSMITHKLINE INC
Current status	Marketed
Current status date	July 16, 2002

Parnate: Uses, Side Effects and Dosage