Isocarboxazid

Isocarboxazid Brand Name– Marplan

What is Isocarboxazid

Isocarboxazid is an oral antidepressant of the monoamine oxidase inhibitor (MAOI) class.

Due to the dietary restrictions required for MAOI use, as well as their side effect profile and the potential for serious drug-drug and drug-food interactions, MAOIs are primarily considered an option for major depressive disorder (MDD) that is refractory to treatment with other antidepressants.

MAOIs may be particularly effective for MDD with atypical features, and are recommended in some treatment guidelines for refractory cases of anxiety disorders such as social anxiety disorder and panic disorder.

Isocarboxazid was initially approved for use by the FDA in 1959, and was previously classified by the FDA as being “probably” effective for the treatment of depressed patients refractory to tricyclic antidepressants (TCAs) or electroconvulsive therapy or in patients with contraindications to TCAs.

Based upon this classification, the manufacturer was required to submit clinical trial data to provide substantial evidence of antidepressant efficacy.

The FDA re-approved isocarboxazid for the second-line treatment of depression in August 1998.

Indications

• depression

Side Effects

1. agitation
2. agranulocytosis
3. akathisia
4. amblyopia
5. anemia
6. anxiety
7. appetite stimulation
8. ataxia
9. chills
10. constipation
11. depression
12. diarrhea
13. dizziness
14. drowsiness
15. dysarthria
16. dysuria
17. edema
18. ejaculation dysfunction
19. elevated hepatic enzymes
20. euphoria
21. hallucinations
22. headache
23. hepatitis
24. hyperhidrosis
25. hypertension
26. hypertensive crisis
27. hypoglycemia
28. impotence (erectile dysfunction)
29. increased urinary frequency
30. insomnia
31. intracranial bleeding
32. jaundice
33. lethargy
34. leukopenia
35. mania
36. memory impairment
37. myoclonia
38. nausea
39. neuritis
40. orgasm dysfunction
41. orthostatic hypotension
42. palpitations
43. paresthesias
44. peripheral edema
45. photosensitivity
46. pseudoparkinsonism
47. seizures
48. serotonin syndrome
49. SIADH
50. suicidal ideation
51. syncope
52. telangiectasia
53. thrombocytopenia
54. tongue discoloration
55. tremor
56. urinary incontinence
57. urinary retention
58. vitamin B6 deficiency
59. weight gain
60. withdrawal
61. xerostomia

Monitoring Parameters

• blood pressure
• heart rate
• LFTs
• serum creatinine/BUN

Contraindications

• abrupt discontinuation
• acute myocardial infarction
• alcoholism
• angina
• anxiety
• asthma
• bipolar disorder
• breast-feeding
• bronchitis
• cardiac disease
• cerebrovascular disease
• children
• coadministration with other CNS depressants
• dental work
• diabetes mellitus
• driving or operating machinery
• ethanol ingestion
• geriatric
• head trauma
• headache
• hepatic disease
• hepatotoxicity
• hypertension
• hypertensive crisis
• hyperthyroidism
• hypotension
• increased intracranial pressure
• intracranial bleeding
• jaundice
• mania
• MAOI therapy
• myocardial infarction
• orthostatic hypotension
• pheochromocytoma
• pregnancy
• psychosis
• radiographic contrast administration
• renal disease
• renal failure
• renal impairment
• schizophrenia
• seizure disorder
• seizures
• spinal anesthesia
• substance abuse
• suicidal ideation
• surgery

Interactions

• Acebutolol
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Tramadol
• Alfentanil
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Aliskiren; Valsartan
• Almotriptan
• Alogliptin
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alpha-blockers
• Alpha-glucosidase Inhibitors
• Alprazolam
• Altretamine
• Ambrisentan
• Amide local anesthetics
• Amifampridine
• Amiloride
• Amiloride; Hydrochlorothiazide, HCTZ
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amlodipine
• Amlodipine; Atorvastatin
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amobarbital
• Amoxapine
• Angiotensin II receptor antagonists
• Angiotensin-converting enzyme inhibitors
• Anxiolytics; Sedatives; and Hypnotics
• Apraclonidine
• Armodafinil
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Oxycodone
• Atenolol
• Atenolol; Chlorthalidone
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Atropine; Difenoxin
• Atropine; Diphenoxylate
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• atypical antipsychotic
• Azilsartan
• Azilsartan; Chlorthalidone
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Belladonna; Opium
• Benazepril
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzhydrocodone; Acetaminophen
• Benzodiazepines
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Benzonatate
• Beta-adrenergic blockers
• Beta-agonists
• Betaxolol
• Bisoprolol
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bosentan
• Bretylium
• Brimonidine
• Brimonidine; Brinzolamide
• Brimonidine; Timolol
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Dextromethorphan; Guaifenesin
• Brompheniramine; Dextromethorphan; Phenylephrine
• Brompheniramine; Guaifenesin; Hydrocodone
• Brompheniramine; Hydrocodone; Pseudoephedrine
• Bumetanide
• Buprenorphine
• Buprenorphine; Naloxone
• Bupropion
• Bupropion; Naltrexone
• Buspirone
• Butabarbital
• Butorphanol
• Caffeine
• Caffeine; Ergotamine
• Calcium-channel blockers
• Canagliflozin
• Canagliflozin; Metformin
• Candesartan
• Candesartan; Hydrochlorothiazide, HCTZ
• Captopril
• Captopril; Hydrochlorothiazide, HCTZ
• Carbamazepine
• Carbetapentane; Chlorpheniramine
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbetapentane; Pseudoephedrine
• Carbetapentane; Pyrilamine
• Carbidopa; Levodopa
• Carbidopa; Levodopa; Entacapone
• Carbinoxamine; Dextromethorphan; Pseudoephedrine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Hydrocodone; Pseudoephedrine
• Carteolol
• Carvedilol
• Cenobamate
• Cetirizine
• Cetirizine; Pseudoephedrine
• Chlordiazepoxide
• Chlordiazepoxide; Clidinium
• Chloroprocaine
• Chlorothiazide
• Chlorpheniramine; Codeine
• Chlorpheniramine; Dextromethorphan
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpromazine
• Chlorthalidone
• Chlorthalidone; Clonidine
• Clevidipine
• Clomipramine
• Clonazepam
• Clonidine
• Clorazepate
• Cocaine
• Codeine
• Codeine; Guaifenesin
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• COMT inhibitors
• Cyclobenzaprine
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Desflurane
• Desipramine
• Desmopressin
• Desvenlafaxine
• Deutetrabenazine
• Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
• Dextromethorphan
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Guaifenesin
• Dextromethorphan; Guaifenesin; Phenylephrine
• Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
• Dextromethorphan; Guaifenesin; Pseudoephedrine
• Dextromethorphan; Promethazine
• Dextromethorphan; Quinidine
• Diazepam
• Diazoxide
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Diltiazem
• Diphenhydramine; Hydrocodone; Phenylephrine
• Dolasetron
• Dorzolamide; Timolol
• Doxazosin
• Doxepin
• Dronabinol
• Droperidol
• Droxidopa
• Duloxetine
• Eletriptan
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Enalapril, Enalaprilat
• Enalapril; Felodipine
• Enalapril; Hydrochlorothiazide, HCTZ
• Enflurane
• Eplerenone
• Epoprostenol
• Eprosartan
• Eprosartan; Hydrochlorothiazide, HCTZ
• Ertugliflozin
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Esketamine
• Eslicarbazepine
• Esmolol
• Estazolam
• Ester local anesthetics
• Ethacrynic Acid
• Ethanol
• Etomidate
• Felbamate
• Felodipine
• Fenfluramine
• Fenoldopam
• Fentanyl
• Fluphenazine
• Flurazepam
• food
• Fosinopril
• Fosinopril; Hydrochlorothiazide, HCTZ
• Fospropofol
• Frovatriptan
• Furosemide
• Gabapentin
• Gallium Ga 68 Dotatate
• General anesthetics
• Ginseng, Panax ginseng
• Glipizide; Metformin
• Glyburide; Metformin
• Granisetron
• Green Tea
• Guaifenesin; Hydrocodone
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Guanabenz
• Guanfacine
• Halothane
• Homatropine; Hydrocodone
• Hydantoins
• Hydralazine
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydralazine; Isosorbide Dinitrate, ISDN
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone
• Hydrocodone; Ibuprofen
• Hydrocodone; Phenylephrine
• Hydrocodone; Potassium Guaiacolsulfonate
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hydromorphone
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibuprofen; Oxycodone
• Iloprost
• Imipramine
• Incretin Mimetics
• Indapamide
• Insulins
• Iobenguane I 131
• Iohexol
• Iopamidol
• Iopromide
• Ioversol
• Irbesartan
• Isoflurane
• Isoniazid, INH
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Isosulfan Blue
• Isradipine
• Ketamine
• Labetalol
• Lamotrigine
• Lasmiditan
• Lemborexant
• Levetiracetam
• Levobetaxolol
• Levobunolol
• Levocetirizine
• Levodopa
• Levomethadyl
• Levomilnacipran
• Levorphanol
• Linagliptin
• Linagliptin; Metformin
• Lisinopril
• Lithium
• Loop diuretics
• Lorazepam
• Lorcaserin
• Losartan
• Loxapine
• Magnesium Salts
• Mannitol
• Maprotiline
• Meglitinides
• Meperidine
• Meperidine; Promethazine
• Mephobarbital
• Mesoridazine
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methadone
• Methazolamide
• Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
• Methohexital
• Methyclothiazide
• Methyldopa
• Methylene Blue
• Metoclopramide
• Metolazone
• Metoprolol
• Midazolam
• Milnacipran
• Minoxidil
• Mirabegron
• Mirtazapine
• Modafinil
• Moexipril
• Morphine
• Morphine; Naltrexone
• Nabilone
• Nadolol
• Nalbuphine
• Naproxen; Sumatriptan
• Naratriptan
• Nateglinide
• Nebivolol
• Nebivolol; Valsartan
• Nefazodone
• Netupitant, Fosnetupitant; Palonosetron
• Nicardipine
• Nifedipine
• Nimodipine
• Nisoldipine
• Nitroglycerin
• Nitroprusside
• Non-Ionic Contrast Media
• Nortriptyline
• Olmesartan
• Ondansetron
• Oxazepam
• Oxcarbazepine
• Oxycodone
• Oxymetazoline
• Oxymorphone
• Ozanimod
• Palonosetron
• Penbutolol
• Pentazocine
• Pentazocine; Naloxone
• Pentobarbital
• Perampanel
• Perindopril
• Perindopril; Amlodipine
• Perphenazine
• Perphenazine; Amitriptyline
• Phenobarbital
• Phenoxybenzamine
• Phentolamine
• Phenylephrine; Promethazine
• Pindolol
• Potassium-sparing diuretics
• Pramlintide
• Prazosin
• Pregabalin
• Primidone
• Procaine
• Procarbazine
• Prochlorperazine
• Promethazine
• Propofol
• Propoxyphene
• Propranolol
• Protriptyline
• Quazepam
• Quinapril
• Ramelteon
• Ramipril
• Rasagiline
• Remifentanil
• Repaglinide
• Reserpine
• Rizatriptan
• Sacubitril; Valsartan
• Safinamide
• Saxagliptin
• Secobarbital
• Sedating H1-blockers
• Selective norepinephrine reuptake inhibitors
• Selective serotonin reuptake inhibitors
• Selegiline
• Serotonin norepinephrine reuptake inhibitors
• Sevoflurane
• Sibutramine
• Sildenafil
• Simvastatin; Sitagliptin
• Sitagliptin
• Sodium Oxybate
• Solriamfetol
• Spironolactone
• St. John’s Wort, Hypericum perforatum
• Succinimides
• Sufentanil
• Sulfonylureas
• Sumatriptan
• Suvorexant
• Sympathomimetics
• Tapentadol
• Tedizolid
• Telmisartan
• Temazepam
• Terazosin
• Tetrabenazine
• Tetracaine
• Tetrahydrozoline
• Thiazide diuretics
• Thiazolidinediones
• Thiethylperazine
• Thiopental
• Thioridazine
• Thiothixene
• Tiagabine
• Timolol
• Torsemide
• Tramadol
• Trandolapril
• Trandolapril; Verapamil
• Trazodone
• Treprostinil
• Triamterene
• Triazolam
• Tricyclic antidepressants
• Trifluoperazine
• Trimipramine
• Valbenazine
• Valerian, Valeriana officinalis
• Valproic Acid, Divalproex Sodium
• Valsartan
• Venlafaxine
• Verapamil
• Vilazodone
• Vortioxetine
• Yohimbine
• Zolmitriptan
• Zonisamide