Take special care with Nardil tablets

You should consult your doctor or pharmacist before taking Nardil if you have any of the following conditions:

• agitation
• epilepsy
• porphyria (which may make the skin sensitive to sunlight, or may affect the nervous system, causing abdominal pain, vomiting, muscle weakness, fits and mental disturbances)
• abnormalities of blood cells, this could be caused by many different diseases and symptoms can include bleeding problems, weakness or pale skin colour, or frequent infections
• diabetes mellitus
• schizophrenia
• manic depression
• if you are taking diuretics (water tablets)
• if you are undergoing ECT (electroshock treatment)
• if you are going to have surgery or major dentistry: tell your doctor or dentist because Nardil may interact with certain anaesthetics and should not be taken for two weeks before surgery.

Your blood pressure should be monitored frequently by your doctor and Nardil should be stopped if palpitations or frequent headaches occur.

Taking other medicines

Please tell your doctor, dentist or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

In particular, tell your doctor if you are taking any of the following medicines, because Nardil may interact with them:

• cough and cold cures, cough medicines
• hay fever medications, asthma inhalant medications
• appetite-suppressing medicines, weight-reducing preparations and ‘pep’ pills
• strong pain killers (pethidine and morphine). This could be a serious reaction
• tryptophan, amphetamines and medicines of the type known as sympathomimetic amines (adrenaline, epinephrine, fenfluramine, ephedrine, phenylpropanolamine, dopamine and levodopa). Some of these may be in medicines bought without a prescription
• medicines used to treat high blood pressure (particularly guanethidine)
• diabetes medications
• antimuscarinic medicines, used to treat motion sickness, muscle cramps in the gut or bladder, or Parkinson’s disease
• medicines which make you sleepy (including barbiturates and alcohol) and local anaesthetics including cocaine. The effect of these medicines may be increased by Nardil
• amfebutamone (to help you give up smoking). This should not be taken at the same time as, or within 14 days of, Nardil
• migraine medications known as 5-HT1 agonists. These should not be taken at the same time as, or within 14 days of, Nardil
• medicines to treat epilepsy, altretamine (for ovarian cancer), doxapram (to stimulate breathing in emergency situations), tetrabenazine (for Huntington’s chorea), oxypertine and clozapine (for schizophrenia and other similar illnesses)
• other antidepressants:
  • other MAOIs, buspirone or dibenzazepine derivative drugs (e.g. tricyclic antidepressants, perphenazine or carbamazepine), selective serotonin re-uptake inhibitors (SSRIs) or serotonin noradrenaline re-uptake inhibitors (SNRIs, e.g. venlafaxine). Nardil should not be taken for 14 days either before or after these medicines.
  • clomipramine or imipramine – 21 days should elapse before starting Nardil.

If you are not sure which medicines you are already taking, please ask your doctor or pharmacist.

Taking Nardil Tablets with food and drink

Nardil tablets react with a substance called tyramine which is found in some foods and drinks (see lists below).

If you eat or drink anything containing tyramine while you are taking Nardil, or within 14 days of taking Nardil, you may have a very severe rise in blood pressure.

This will happen soon after eating the food and you may get a violent headache, pounding heart, stiff neck, flushing, sweating or you may be sick. The severity of the reaction depends on the amount of tyramine you eat and may be mild or could be dangerous, even fatal.

If you feel such a reaction happening, tell your doctor or go to your nearest hospital accident and emergency department immediately.

Do not eat:

Cheese (cooked or plain), liver, yoghurt, yeast/meat extracts (e.g. Marmite, Oxo, Bovril or Brewer’s yeast), flavoured textured vegetable protein, broad bean pods, protein which has been allowed to age, degrade or ferment (e.g. hung game, pickled herrings or dry sausage such as salami or pepperoni), fermented soya bean extract, excessive amounts of chocolate.

Do not drink:

Alcohol, non-alcoholic beer, lager or wine. You may drink a reasonable amount of tea or coffee but not to excess.

Pregnancy and breast-feeding

Nardil is not recommended for use during pregnancy, especially during the first and last trimesters. If you are pregnant, think you might be pregnant or are planning to become pregnant, you should talk to your doctor.

Do not breast-feed if you are taking Nardil.

As with any medicine, ask your doctor or pharmacist for advice.

Driving and using machines

Nardil might cause drowsiness or blurred vision. Do not drive or operate machinery until you know if the tablets affect you in this way.

Important information about some of the ingredients of Nardil Tablets

Sunset yellow (E110), a colouring agent in the film coating of Nardil, may cause an allergic reaction.