Moclobemide belongs to the class of antidepressants known as monoamine oxidase (MAO) inhibitors. It is used to treat depression. Depression is believed to be caused by imbalances in certain brain chemicals. This medication works by bringing these chemicals back into balance.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

The recommended dose of moclobemide for adults ranges from 150 mg to 300 mg, taken twice daily after meals. The usual starting dose is 150 mg twice daily. If necessary, your doctor may increase your dose gradually to a maximum of 300 mg twice daily. This medication may take a few days to several weeks to achieve the best effect. Unlike other MAO inhibitors, no special dietary restrictions are necessary when taking moclobemide. It is very important, however, to always take this medication immediately after you have eaten.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you take the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by the doctor. Do not stop taking this medication, even if you start to feel better, without first talking with your doctor. If you miss a dose, take it as soon as possible and continue on with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue on with your regular dosing schedule. Do not double doses.

150 mg: Each pale yellow, film-coated tablet, imprinted "ROCHE" over "150" on one side and single-scored on the other, contains moclobemide 150 mg. Nonmedicinal ingredients: cornstarch, ethylcellulose, iron oxide, lactose, magnesium stearate, methylhydroxypropyl cellulose, polyethylene glycol, povidone, sodium starch glycolate, talc, and titanium dioxide. The 150 mg tablets do not contain gluten, parabens, sucrose, sulfites, or tartrazine.

300 mg: Each white, film-coated tablet, imprinted "ROCHE" over "300" on one side and single-scored on the other, contains moclobemide 300 mg. Nonmedicinal ingredients: cornstarch, ethylcellulose, lactose, magnesium stearate, methylhydroxypropyl cellulose, polyethylene glycol, povidone, sodium starch glycolate, talc, and titanium dioxide.

Moclobemide should not be used by anyone who:

• is allergic to the medication or any of its ingredients
• is in an acute confusional state
• already takes tricyclic antidepressants (e.g., amitriptyline), SSRI antidepressants (e.g., fluoxetine), other MAO inhibitors (e.g., tranylcypromine, phenelzine), or meperidine
• is younger than 18 years of age

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. Your health professional may be able to help you deal with some of the effects.

The following side effects may go away as your body becomes used to the medication; check with your doctor if they continue or become bothersome.

More common:

• dryness of mouth
• trembling or shaking of arms or legs

  Less common or rare:

• abdominal or stomach pain or discomfort
• change in taste sensation
• constipation
• diarrhea
• dizziness
• drowsiness
• feeling of warmth of the face, neck, arms, and, occasionally, upper chest
• heartburn or indigestion
• increased or decreased appetite
• increased sweating
• joint or muscle pain
• nightmares
• trouble sleeping.

Check with your doctor as soon as possible if any of the following side effects occur:

More common:

• mild-to-moderate headache, or pressure in the head

  Less common:

• anxiety
• blurred vision or other changes in vision
• dizziness, faintness, or lightheadedness, especially when rising from a sitting or lying position
• fast or racing heartbeat
• high blood pressure
• irritability
• nervousness
• pounding or irregular heartbeat
• restlessness
• unusual tiredness or weakness

Rare:

Stop taking this medication and check with your doctor immediately if any combination of the following symptoms occur:

• fast or racing heartbeat
• pounding or irregular heartbeat
• neck stiffness
• severe throbbing headache which starts at the back of the head and radiates forward
• slow heartbeat

Get emergency help immediately if any of the following symptoms of overdose occur:

• agitation
• confusion
• convulsions (seizures)
• decreased reflexes
• extreme drowsiness
• high blood pressure
• loss of memory
• nausea
• slurred speech
• vomiting

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Alcohol: Avoid excessive alcohol consumption.

Diet restriction: Treatment with moclobemide does not require special diet restrictions as with other MAO inhibitors such as phenelzine. As a safety measure, be sure to report immediately the sudden occurrence of any of the following:

• headache
• palpitations
• neck stiffness
• extremely fast or slow heart rate
• other unusual symptoms not previously experienced

Occupational hazards: Do not drive or perform hazardous tasks until you determine the effect moclobemide has on you.

Other medications: Treatment with a tricyclic antidepressants may be started after moclobemide has been stopped for at least 2 days.

Do not start treatment with moclobemide until antidepressants have been stopped for 2 weeks in most cases (wait 5 weeks after taking fluoxetine).

Reduced kidney function: People with reduced kidney function should use moclobemide with caution.

Reduced liver function: For people with severe liver dysfunction, the daily dose of moclobemide should be reduced to one-third or one-half of the standard dose.

Pregnancy: The safety of using moclobemide during pregnancy has not been established. Therefore, this medication is not recommended for women who may be pregnant, unless, in the opinion of their doctor, the expected benefits markedly outweigh the possible risks. If you are or may be pregnant, talk to your doctor about the risks and benefits of this medication.

Breast-feeding: It is believed that small amounts of moclobemide pass into breast milk. Therefore, moclobemide is not recommended for nursing mothers unless the anticipated benefits outweigh the potential harm to the infant. If you are breast-feeding, talk to your doctor.

• alcohol
• amphetamines (e.g., dextroamphetamine)
• appetite suppressants (e.g., sibutramine, mazindol)
• anesthetics (e.g., halothane)
• antipsychotic medications (e.g., haloperidol)
• buspirone
• cimetidine
• decongestants (e.g., pseudoephedrine)
• dextromethorphan
• narcotic medications (e.g., morphine, codeine)
• other MAO inhibitors (e.g., phenelzine, tranylcypromine)
• SSRI antidepressants (e.g., fluoxetine, paroxetine)
• sympathomimetic medications (e.g., epinephrine)
• tricyclic antidepressants (e.g., amitriptyline, desipramine)

Moclobemide may affect how the following medications work:

• medications that lower blood pressure

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than the ones listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.