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MONOAMINE OXIDASE INHIBITOR (MAOI)
Nardil (phenelzine sulfate) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating adults with certain kinds of depression.
Nardil is a type of medication called a monoamine oxidase (MAO) inhibitor. It works by blocking an enzyme in the body called monoamine oxidase. In depression, this may help reduce symptoms by changing brain chemicals linked to mood.
The exact way it works is not fully known.
Nardil is often used in people who have both anxiety and depression, or when other antidepressants have not worked well. By targeting this pathway, the medication may help manage symptoms.
Nardil comes as a tablet that you take by mouth. Most people start by taking it three times a day. If the medicine helps, the doctor may slowly lower the dose over time.
The recommended starting dose of Nardil for depression is one tablet (15 milligrams) taken three times a day.
Doctors may raise the dose fairly quickly to at least 60 milligrams per day, and sometimes up to 90 milligrams per day. Many people need to take 60 milligrams for at least four weeks before they feel better.
After the medicine is working well, the doctor should slowly lower the dose over several weeks.
Some people may take a lower dose, such as 15 milligrams once a day or every other day, to keep their symptoms under control.
This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
In clinical studies of Nardil for depression, the most common side effects tended to be mild to moderate in severity. They may get better as treatment continues.
These were:
Nardil can cause serious side effects that require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
Pfizer, the manufacturer of Nardil, offers Pfizer RxPathways. Eligible people may receive Nardil at no cost ($0 copay) through the Pfizer Patient Assistance Program (PAP). Uninsured or publicly insured eligible people may also receive Nardil at no cost.
Pfizer RxPathways also provides insurance support and guidance through trained Medicine Access Counselors. They can help you understand your coverage, verify benefits, and navigate reimbursement and enrollment processes. To learn more, visit Pfizer RxPathways or call 844-989-7284.
Before starting Nardil, your doctor may check your mental health history to see if you are at risk for bipolar disorder.
While taking Nardil, your blood pressure should be checked often. You must also avoid certain foods and drinks, such as aged cheeses, cured meats, and alcohol, because they can cause a dangerous rise in blood pressure.
Tell your doctor if you have any allergies to phenelzine sulfate or any ingredients in Nardil. Do not take Nardil if you are allergic to it or its ingredients.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Many common cold, cough, and decongestant medicines should not be used with Nardil.
Do not take Nardil if you have certain health problems, such as a tumor called pheochromocytoma, heart failure, serious kidney disease, or liver problems.
Do not take Nardil with certain medicines. These include meperidine, dextromethorphan, buspirone, bupropion, other MAO inhibitors, and many antidepressants.
You must wait at least 14 days between stopping one medicine and starting another. If you are switching from fluoxetine, you should wait at least five weeks.
Tell any doctor or dentist that you are taking Nardil. You may need to stop it at least 10 days before surgery.
Nardil is not approved for use in children.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Nardil, talk with your doctor about the risks and benefits.
These answers are fact-checked by our editorial staff.
How effective is Nardil?
Nardil can help some people with certain types of depression. It works best in people whose depression is described as atypical, nonendogenous, or neurotic. These people often also have anxiety, strong fears, or worry a lot about their health.
Nardil is usually used after other antidepressants have not worked.
Many people do not feel better right away. It may take at least four weeks at a dose of 60 milligrams a day to see improvement. There is less clear evidence that Nardil works well for people with more severe types of depression.
How long does Nardil take to work for depression?
Nardil may take a few weeks to start working. Many people do not feel better until they have taken 60 milligrams a day for at least four weeks.
Most people start with 15 milligrams taken three times a day. The doctor may increase the dose fairly quickly based on tolerance.
Can Nardil be used with other medicines for depression?
Nardil should not be used with many other medicines because some combinations can cause serious or even life-threatening reactions.
Do not take Nardil with other monoamine oxidase inhibitors, certain antidepressants that affect serotonin, such as fluoxetine, sertraline, citalopram, and venlafaxine, or with bupropion.
You must wait at least 14 days between stopping Nardil and starting another antidepressant, or the other way around. If you are switching from fluoxetine to Nardil, you should wait at least five weeks.
Always talk to your doctor before starting or stopping any medicines.
On MyDepressionTeam, people share their experiences with depression, get advice, and find support from others who understand.
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