Phenelzine (Nardil) is a MAOI antidepressant that may cause hypertensive crisis and has multiple interactions with commonly prescribed medications, Epinephrine, and local anesthetics. Build your knowledge by reading on:
Generic Name: Phenelzine Sulfate
Brand Name(s): Nardil
Pronunciation: FEN el zeen
About this drug:
Phenelzine is a monoamine oxidase inhibitor (MAOI) used to treat atypical depression in adults, and is typically prescribed when other medications have not been effective.
Dentistry-related tidbits:
Phenelzine may cause xerostomia.
If a narcotic must be prescribed, consider an alternative opioid (e.g., Hydrocodone, Oxycodone, or Oxymorphone).
Dangerous drug interactions can occur between Phenelzine and certain other medications if combined within 14 days before or after taking Phenelzine. Speak with the patient's psychiatrist before prescribing any medications. Make sure to check for potential interactions before prescribing using a tool like Rx Check.
Hypertensive crisis is a serious possible side effect of Phenelzine. Check the patient's blood pressure before any dental procedure. Refer the patient to their physician or the Emergency Room if they complain about hypertensive crisis symptoms.
Avoid using local anesthetics with Epinephrine when a patient is taking Phenelzine to avoid an increased risk of severe prolonged hypertension.
Monitor blood pressure when administering the following local anesthetics to a patient taking Phenelzine, as the combination may increase the risk of hypotension including orthostasis: Articaine (Septocaine), Bupivacaine (Marcaine), Lidocaine (Xylocaine), Mepivacaine (Carbocaine), Ropivacaine (Naropin).
Fun facts:
One of the most significant concerns with MAOIs is the potential for a hypertensive crisis. This can occur if Phenelzine is taken with foods or beverages rich in tyramine, leading to a sudden and dangerous increase in blood pressure.
While rare, the use of Phenelzine carries the risk of serotonin syndrome, a potentially life-threatening condition characterized by symptoms such as fever, rapid heart rate, muscle stiffness, and confusion.
Be aware that there is an FDA Warning that some children, adolescents, and young adults may have increased thoughts of self-harm and suicide while taking Phenelzine.
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