 Fresh fish, meat and poultry  Fruit juice and squash  Cottage cheese, cream cheese, fresh yoghurt (associated with minimal risk)  Eggs and milk  Butter, margarine Foods to Avoid When  Tea, coffee and fizzy drinks in moderation  Use meat juices or gravy browning for gravies and sauces Taking Monoamine  Plain crisps, nuts, sweets, chocolate (in moderation) and toffees Oxidase Inhibitor (MAOI) Remember to check all medications taken with the pharmacist and always read the manufacturer’s patient Medicines information leaflet supplied with your medication.

Large print If you would like a large print or taped version of this leaflet, please contact our communications department on 01273 1. isocarboxazid 242093 2. phenelzine (Nardil®)

Produced by: - 3. tranylcypromine

The Dietetic Department, Brighton and Hove, Sussex Partnership NHS Trust, Reversible Tel: - 01273 621984 ext 2364

The Pharmacy Team, 1. moclobemide (Manerix®) Sussex Partnership NHS Foundation Trust,

Tel: - 01323 440022 ext 3523 Produced February 2008 Updated July 2009 Updated May 2013 To be reviewed by February 2017

Monoamine Oxidase Inhibitor (MAOI) Medicines Any foods which do cause a reaction, e.g. throbbing headaches or flushes and high blood pressure, should be recorded and MAOI medicines belong to a group of medicines called discussed with your doctor or pharmacist antidepressants that are used to treat depression. They can react with tyramine, a chemical present in some foods, causing your blood pressure to rise. There are two types of Alcohol MAOI medicines; the older types (isocarboxazid, phenelzine and tranylcypromine) can provoke a more severe reaction Due to the yeast involved in the brewing process avoid alcohol, with tyramine containing foods. The newer reversible MAOI low alcohol and non-alcohol beers, lagers and wines. Drinks that medicine, moclobemide is less likely to cause a severe may particularly be a problem include chianti, homemade beers reaction with tyramine containing foods but large quantities and wines, real ales and red wine. of food containing tyramine should be avoided. Foods which may on rare occasions cause a reaction It is very important whilst taking MAOI medications and for two weeks after stopping the tablets that certain dietary restrictions  Overripe avocados or broad beans, canned or overripe figs are followed, as it takes a long time for the medicine to be  Soya sauce, fermented soya products, Worcestershire sauce removed from the body. The diet restrictions are to limit the  Shrimp paste amount of tyramine containing foods eaten.  Too much caffeine, e.g. coffee, tea or cola unless Foods that can cause a severe reaction decaffeinated  Too much chocolate  Cheese: hard, soft, mature, processed or cheese spreads  Ginseng  Foods containing cheese: e.g. pizzas, lasagne, pies, quiche  Plums, raspberries (in large amounts)  Sour cream  Spinach (in large amounts) or sauerkraut  Meat or yeast extracts or meals containing these extracts, e.g. Bovril®, Oxo®, Marmite®, gravy granules, stock cubes,  Sausages brewer’s yeast  Vinegar  Savoury meal replacements: Complan®/Build-Up® soups  Artificial sweeteners

 Tinned or packet soups  Tinned meats or ready made dishes Foods to try and eat instead Always try to eat a balanced diet, with plenty of fruit and  Smoked or pickled fish, e.g. herrings, caviar, salted dried fish vegetables and not too many fatty foods.  Game, fermented sausage, pâtés, e.g. salami/pepperoni, Eat fresh foods wherever possible black pudding Eat defrosted foods within 24 hours of thawing  Broad bean pods, banana skins  All fruit and vegetables (see above)  Flavoured crisps  Homemade soups  Any food that has been kept for a long time or has  All cereal and cereal products gone mouldy  Unflavoured textured vegetable protein (TVP) List continued overleaf…