Home Drug Guide Pargyline Hydrochloride

Drug Guide

Generic Name

Pargyline Hydrochloride

Brand Names Eutonyl

Classification

Therapeutic: Antihypertensive, Monoamine Oxidase Inhibitor (MAOI)

Pharmacological: Non-selective Monoamine Oxidase Inhibitor

FDA Approved Indications

Management of hypertension unresponsive to other therapy

Mechanism of Action

Pargyline inhibits monoamine oxidase (MAO), leading to increased levels of norepinephrine, dopamine, and serotonin in the central nervous system and peripheral tissues, resulting in vasodilation and decreased blood pressure.

Dosage and Administration

Adult: Initially 20 mg 2-3 times daily, titrated as needed up to 40-50 mg 2-3 times daily.

Pediatric: Use not well established; generally not recommended.

Geriatric: Start at lower doses due to increased sensitivity and potential for adverse effects.

Renal Impairment: Adjust dose cautiously; renal function should be monitored.

Hepatic Impairment: Use with caution; hepatic function should be assessed.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Wide distribution; crosses the blood-brain barrier.

Metabolism: Metabolized in the liver.

Excretion: Excreted primarily in the urine.

Half Life: Approximately 2-4 hours, but effects may last longer due to enzyme inhibition.

Contraindications

History of hypersensitivity to pargyline or other MAO inhibitors.
Concurrent use with other MAO inhibitors, SSRIs, or tyramine-rich foods.

Precautions

Use with caution in patients with hepatic impairment, cardiovascular disease, or psychiatric disorders. Avoid foods high in tyramine to prevent hypertensive crises. Monitor blood pressure regularly.

Adverse Reactions - Common

Orthostatic hypotension (Common)
Dizziness (Common)
Insomnia (Common)

Adverse Reactions - Serious

Hypertensive crisis due to tyramine interactions (Rare)
Serotonin syndrome (when combined with serotonergic drugs) (Rare)
Liver toxicity (Rare)

Drug-Drug Interactions

Other MAO inhibitors, SSRIs, SNRIs, TCAs, sympathomimetics, vasoconstrictors.

Drug-Food Interactions

Foods high in tyramine (aged cheese, smoked meats, fermented foods)

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure regularly; assess for symptoms of hypertensive crisis.

Diagnoses:

Risk for hypertensive crisis
Altered blood pressure regulation

Implementation: Educate patient on dietary restrictions; avoid tyramine-rich foods; monitor for adverse reactions.

Evaluation: Effectiveness in blood pressure control; absence of hypertensive episodes.

Patient/Family Teaching

Instruct about the importance of dietary restrictions to prevent hypertensive crises.
Advise to report symptoms such as severe headache, neck stiffness, or palpitations immediately.

Special Considerations

Black Box Warnings:

Hypertensive crisis risk with tyramine-rich foods.
Potential for serotonin syndrome when combined with serotonergic agents.

Genetic Factors: Genetic variations affecting MAO enzyme may influence drug response.

Lab Test Interference: May interfere with laboratory tests for monoamine oxidase activity.

Overdose Management

Signs/Symptoms: Severe hypertension, hyperthermia, chest pain, seizures.

Treatment: Supportive care; quick removal of drug; antihypertensive medications as needed; Manage seizures accordingly.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under recommended storage conditions.