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PARNATE® TABLETS ( 10 mg) Consumer Medicine Information WHAT IS IN THIS LEAFLET Do not take Parnate and talk to your Do not give this medicine to anyone else. doctor if you have taken any other Your doctor has prescribed it specifically for This leaflet answers some of the common medicines for the treatment of you and your condition. questions about Parnate. It does not contain or anxiety within the last 5 weeks and If you are not sure whether you should all the available information. It does not take have not discussed this with your doctor. start taking this medicine, talk to your the place of talking to your doctor or This includes: doctor. pharmacist. • Selective Inhibitors Before you start to take it All medicines have risks and benefits. Your (SSRIs), e.g. , , Tell your doctor if you have allergies to doctor has weighed the risks of you taking Parnate against the benefits they expect it any other medicines, foods, preservatives • Serotonin- Reuptake will have for you. or dyes. Inhibitors (SNRIs), e.g. If you have any concerns about taking this Tell your doctor if you have or have had • , e.g. medicine, ask your doctor or pharmacist. any of the following medical conditions: , , • diabetes Keep this leaflet with the medicine. , desipramine, You may need to read it again. (dothiepin), , • epilepsy (condition where you have or repeated fits or convulsions) WHAT PARNATE IS USED FOR • hydrochloride • angina (chest pain) Parnate is used to treat symptoms of Do not take Parnate and talk to your • kidney problems depression, especially if treatment with other doctor if: • addiction to drugs or types of antidepressants has failed. There are • you are taking, or being treated with, any • angle-closure glaucoma (sudden rise in many different types of medicines used to of the following: intra-ocular pressure) treat depression. Parnate belongs to a group - appetite suppressants such as • sugar intolerance. of medicines called monoamine oxidase , , Tell your doctor as soon as possible if you inhibitor (MAOI) antidepressants. It contains (e.g. Duromine), the active ingredient tranylcypromine. are planning to have any type of surgery. or diethylpropion for weight loss Parnate may interfere with some medicines Depression is longer lasting or more severe - , used during surgery. than the ‘low moods’ that everyone has from or other central nervous system time to time. It is thought to be caused by a Tell your doctor if you are pregnant or chemical imbalance in parts of the brain. The - cold or hayfever medicines, including plan to become pregnant. imbalance affects your whole body and can nose drops or sprays Your doctor will discuss the risks and cause emotional and physical symptoms. - , contained in many benefits of using Parnate if you are pregnant. You may feel low in spirit, lose interest in cough and cold medicines you can buy If you take this medicine during the last three usual activities, be unable to enjoy life, have without a prescription months of your pregnancy, the general poor appetite or overeat, have disturbed - , , or condition of your newborn baby might be sleep, often waking up early, low energy and any other medicine that affects blood affected. feel guilty over nothing. pressure Tell your doctor if you are breastfeeding Parnate corrects the chemical imbalance and - strong pain killers, e.g. , or planning to breastfeed. helps relieve the symptoms of depression. It , Your doctor will discuss the risks and is not recommended for the ‘low moods’ that - levodopa (e.g. Madopar or Sinemet) benefits involved. It is not recommended that everyone has from time to time due to the for Parkinson’s disease you breastfeed while taking Parnate as it stress or sadness of everyday life. - , used to treat epilepsy, passes into breast milk. Your doctor may have prescribed Parnate for nerve pain, mania or bipolar disease Taking other medicines another use. - , used to help stop smoking Tell your doctor or pharmacist if you are - , a dietary supplement to Ask your doctor if you have questions taking any other medicines, including any treat depression or anxiety or help you about why Parnate has been prescribed that you get without a prescription from sleep for you. your pharmacy, supermarket or health • you have or have had any of these Parnate is available only with a doctor’s food shop. medical conditions: prescription. Some medicines and Parnate may interfere - a stroke, poor blood flow to the brain, with each other. or frequent headaches BEFORE YOU TAKE PARNATE Tell your doctor or pharmacist if you are - heart disease or high blood pressure taking any of the following: When you must not take it - disease - hyperthyroidism (overactive thyroid • any medicine listed under ‘When you Do not take Parnate if you have an allergy gland) must not take it’ to: - blood or bone marrow disorder • , or any other • Parnate or any other medicine containing - porphyria, a rare blood pigment medicine that affects blood pressure tranylcypromine disorder • , medicines to help you sleep, • any of the ingredients listed at the end of - phaeochromocytoma, an reduce anxiety or induce anaesthesia this leaflet. (epinephrine) producing tumour of the • medicines, e.g. , Some of the symptoms of an allergic reaction adrenal gland which are used to treat a range of may include: • you are over 60 years of age. medical conditions • shortness of breath Do not give Parnate to children and • medicines used to treat Parkinson’s • wheezing or difficulty breathing adolescents under 18 years of age. Disease • swelling of the face, lips, tongue or other The safety of Parnate in this age group has • medicines used to treat diabetes not been established. parts of the body • medicines used to treat epilepsy Do not take this medicine after the expiry • rash, itching or hives on the skin. • anticoagulants, used to treat blood date printed on the pack or if the Do not take Parnate if you have taken it or clotting disorders packaging is torn or shows signs of any other MAOI medication (e.g. , tampering. • , used to treat allergies , furazolidone, , If it has expired or is damaged, return it to • metrizamide, a contrast medium used in , , pargyline, your pharmacist for disposal. medical imaging. procarbazine hydrochloride) before and became unwell. Tell your doctor or These medicines may be affected by Parnate pharmacist before taking the first dose. or may affect how well it works. You may

PARNATE® TABLETS Published by MIMS May 2020 1 need different amounts of your medicines, or you were taking it and stopped less than Things to be careful of you may need to take different medicines. two weeks ago. Watch carefully for signs that your Your doctor will advise you. This applies to medicines that you buy depression or anxiety is getting worse, Your doctor and pharmacist have more without a prescription as well as prescription especially in the first few weeks of information on medicines to be careful with medicines. treatment. or avoid while taking Parnate. Tell any other doctors, dentists, and Tell your doctor immediately if you pharmacists who treat you that you are experience any of the following symptoms, HOW TO TAKE PARNATE taking this medicine. especially if they are severe, you have not Follow all directions given to you by your If you are going to have surgery or had these symptoms before or they doctor or pharmacist carefully. emergency treatment, tell your doctor or happen very suddenly: They may differ from the information dentist that you are taking Parnate or • anxiety or agitation have used it in the last two weeks. contained in this leaflet. • panic attacks It may affect other medicines used during If you do not understand the instructions surgery. • difficulty sleeping on the pack, ask your doctor or • hostility or impulsiveness pharmacist for help. Carry an alert card or wear an SOS bracelet, which tells the doctor, dentist or • restlessness How much to take pharmacist you are taking Parnate. • overactive or uninhibited behaviour The usual dose of Parnate is one 10 mg tablet These are helpful if you are in an accident • thoughts of suicide. taken twice a day. and cannot talk. Tell your doctor immediately if you have How to take it You must avoid certain foods and drinks any thoughts about suicide or doing harm Swallow Parnate tablet(s) whole with a full during treatment with Parnate and for at to yourself. glass of water or another liquid. Do not chew least a week after stopping therapy. All thoughts or talk about suicide or violence the tablets. Avoid protein foods that have been aged are serious. The risk is increased in young When to take it or fermented to improve flavour. Also adults aged 18 - 24 years. Improvement may avoid any foods that have caused you not occur during the initial treatment period Parnate tablets are usually taken in the unpleasant reactions previously. morning and at midday. Take the last dose of (usually one to two months). the day not later than 3 pm. This will help While taking Parnate, you should avoid: If you or someone you know is showing avoid sleep disturbances. • matured cheese the following warning signs, either contact How long to take it • meat, fish, poultry, pate or yoghurt that your doctor or a mental health advisor is stale or smells “off” right away or go to the nearest hospital for For depression, the length of treatment will treatment: depend on how quickly your symptoms • protein extracts such as Marmite, • thoughts or talk about death or suicide improve. Most antidepressants take time to Vegemite, Bonox, Bovril, Promite work, so do not be discouraged if you do not • pods of broad beans, sauerkraut • thoughts or talk about self-harm or doing harm to others feel better right away. Some of your • smoked or pickled fish • any recent attempts of self-harm symptoms may improve in 1 or 2 weeks, but • sour cream it can take up to 4 or 6 weeks to feel any real • increase in aggressive behaviour, • soy bean products, e.g. soy sauce, miso, improvement. Even when you feel well, you irritability or agitation. tofu will usually have to take Parnate for several Be careful driving or operating machinery • avocados months or longer. Continue taking Parnate until you know how Parnate affects you. until the doctor tells you to stop. • yeast extracts Parnate may cause drowsiness, dizziness or If you forget to take it • banana skins light-headedness in some people. Make sure Do not take a double dose to make up for • red wines such as Chianti you know how you react to Parnate before the dose that you missed. Wait until the • home brewed beers or liqueurs. you drive a car or operate machinery. next dose and take your normal dose then. Parnate reacts with a chemical found in these Be careful when drinking alcohol while Do not try to make up for the dose that you foods. This reaction may cause sudden high you are taking this medicine. missed by taking more than one dose at a blood pressure which may be experienced as If you drink alcohol, drowsiness, dizziness or time. This may increase the chance of you severe headache, stiff or sore neck, nausea, light-headedness may be worse. getting an unwanted . vomiting, fast or slow heartbeat, changes in If you take too much (overdose) vision, or sweating with initial paleness then SIDE EFFECTS sometimes followed by flushing of the skin. Immediately telephone your doctor or the Tell your doctor or pharmacist as soon as Poisons Information Centre (telephone in Avoid large amounts of - possible if you do not feel well while you Australia 13 11 26; telephone in New containing foods or drinks such as are taking Parnate. Zealand 0800 POISON or 0800 764 766) chocolate, coffee, tea or cola during This medicine helps most people with for advice, or go to the Accident and treatment with Parnate and for at least a depression, but it may have unwanted side Emergency Department at your nearest week after ceasing therapy. effects in some people. All medicines can hospital, if you think that you or anyone These may trigger off a migraine-like have side effects. Sometimes they are else may have taken too much Parnate. headache in some people taking Parnate. serious, most of the time they are not. You Do this even if there are no signs of Things you must not do may need medical attention if you get some discomfort or poisoning. Do not take Parnate to treat any other of the side effects. You may need urgent medical attention. complaints unless your doctor tells you to. Do not be alarmed by the following lists of Symptoms of an overdose commonly include Do not give your medicine to anyone else, side effects. You may not experience any fast heartbeat, sweating, fever, restlessness even if they have the same condition as of them. and excitement. Tremors, depression, stupor you. Ask your doctor or pharmacist to answer or coma may also be present or develop. Do not stop taking your medicine or any questions you may have. Blood pressure may increase but it also could change the dose without checking with Tell your doctor or pharmacist if you drop lower than normal. your doctor. notice any of the following and they worry Some people may suffer symptoms such as you: WHILE YOU ARE USING dizziness or anxiety if Parnate is stopped • rash PARNATE suddenly. If possible, your doctor will • dizziness or blurred vision Things you must do gradually reduce the amount you take each day before stopping the medicine • drowsiness, weakness or fatigue If you are about to be started on any new completely. • feeling numbness or pins and needles medicine, remind your doctor, pharmacist • difficulty sleeping or dentist that you are taking Parnate or if • chills, tremors

PARNATE® TABLETS Published by MIMS May 2020 2 • nervousness Disposal • dry mouth If your doctor tells you to stop taking • nausea, vomiting Parnate or the expiry date has passed, ask • , diarrhoea your pharmacist what to do with any tablets that are left over. • stomach pain, loss of appetite • ringing in the ears PRODUCT DESCRIPTION • swelling in ankles or limbs What it looks like • excess sweating Parnate tablets are red, round, biconvex film • sexual problems. coated tablets. Each Parnate tablet contains Tell your doctor immediately if you notice 10 mg of tranylcypromine (as sulfate). any of the following: Parnate comes in packs of 50 tablets. • thoughts of suicide Ingredients • severe dizziness or fainting on standing Parnate contains 10 mg of tranylcypromine • fever as the active ingredient. It also contains: • unusual bleeding or bruising • calcium sulfate dihydrate • yellowing of the skin and eyes • maize starch (jaundice) • sucrose • agitation, confusion or nervousness • stearate • muscle spasms or twitches • gelatin • difficulty passing . • erythrosine aluminium lake The above list includes serious side effects • Opadry complete film coating system that may require medical attention. 06H250000 Red PI (106298) Stop taking Parnate and contact your • carnauba wax. doctor or go to the Emergency Department of your nearest hospital if any Parnate tablets do not contain lactose, gluten of the following happens: or tartrazine. • serious allergic reaction (swelling of the Sponsor face, lips, mouth or throat which may Distributed in Australia by: cause difficulty swallowing or Amdipharm Mercury (Australia) Pty Ltd breathing) Level 9, 76 Berry Street • chest palpitations, fast heartbeat or North Sydney NSW 2060 frequent headaches Australian registration number: AUST R • headache which may start at the back of 174086 the head and radiate forward, Distributed in New Zealand by: accompanied by chest pain, palpitations, Boucher & Muir (NZ) Ltd t/a Mercury neck stiffness or soreness, nausea, Pharma (NZ) vomiting, either fast or slow heartbeat, 39 Anzac Road sweating, with initial paleness Browns Bay sometimes followed by flushing of the Auckland 0753 skin, enlarged pupils and light sensitivity. This leaflet was revised on 05 March 2020. The above list includes very serious side Amdipharm Mercury (Australia) Pty Ltd is effects. You may need urgent medical licensed to use the trademark Parnate. attention or hospitalisation. Some side effects (for example, changes in liver function or blood) can only be found when your doctor does tests from time to time to check your progress. Tell your doctor or pharmacist if you notice anything that is making you feel unwell. Other side effects not listed above may also occur in some people.

AFTER USING PARNATE Storage Keep your tablets in the blister pack until it is time to take them. If you take the tablets out of the pack they may not keep well. Keep the pack in a cool dry place where the temperature stays at or below 25°C. Do not store Parnate in the bathroom or near a sink. Do not leave it on a window sill or in the car. Heat and dampness can destroy some medicines. Keep Parnate where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

PARNATE® TABLETS Published by MIMS May 2020 3