👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Pharmacological Therapies🔖 Free to read, print, and share
Also known as: Nardil · MAOI antidepressant · monoamine oxidase inhibitor
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Use this quick-reference guide to spot, treat, and prevent Phenelzine on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Uses
Atypical/refractory depression
Blocks MAO → ↑ all monoamines
📌 Avoid
NO tyramine: aged cheese, wine, cured
No SSRIs, sympathomimetics, OTC cold
🚩 Report
HTN crisis: severe HA, stiff neck
Palpitations, sweating, nausea
🎓 Teach
2 wk washout to/from other antidepress
Carry food list, rise slowly (ortho)
📚 Phenelzine — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Phenelzine is a monoamine oxidase inhibitor (MAOI) reserved for atypical or treatment-resistant depression because of major dietary and drug interactions. It blocks the enzyme that breaks down tyramine, so eating tyramine-rich foods can trigger a hypertensive crisis. MAOIs are a high-alert teaching priority on the NCLEX. Memory aid: avoid aged, fermented, smoked, and pickled foods.
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Key points
Understand these first
Tyramine-rich foods (aged cheese, cured/smoked meats, fermented soy, draft beer, red wine, pickled/overripe foods) can cause hypertensive crisis.
Combining with SSRIs, SNRIs, TCAs, meperidine, or sympathomimetics risks serotonin syndrome or hypertensive crisis.
A 14-day washout is required between an MAOI and other serotonergic antidepressants (both directions).
Effect on mood takes 2-4 weeks; orthostatic hypotension is a common early side effect.
OTC decongestants, cold remedies, and stimulants must be avoided.
Carries the antidepressant suicide black box warning.
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Nursing priorities
What to do, in order
Teach the tyramine-restricted diet thoroughly and verify understanding.
Monitor blood pressure and assess for orthostatic hypotension.
Review all prescription, OTC, and herbal products for interactions before administering.
Ensure adequate washout period when switching antidepressants.
Assess for suicidal ideation early in therapy.
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Red flags — report now
Escalate immediately
Hypertensive crisis: severe occipital headache, palpitations, stiff neck, sweating, nausea - emergency, hold and report immediately.
Serotonin syndrome with concurrent serotonergic drugs.
Never combine with SSRIs/SNRIs/TCAs/meperidine or give without a 14-day washout.
New or worsening suicidal thoughts.
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Patient teaching
What patients must know
Strictly avoid tyramine-rich foods: aged cheese, cured/smoked/processed meats, fermented soy, draft beer, red wine, pickled or overripe foods.
Do not take any OTC cold, cough, or decongestant products without provider approval.
Report severe headache, palpitations, or neck stiffness immediately - it may be a hypertensive crisis.
Change positions slowly to avoid dizziness from low blood pressure.
❓ Phenelzine: NCLEX FAQs
What are the priority nursing interventions for Phenelzine?
Teach the tyramine-restricted diet thoroughly and verify understanding. Monitor blood pressure and assess for orthostatic hypotension. Review all prescription, OTC, and herbal products for interactions before administering. Ensure adequate washout period when switching antidepressants.
What are the warning signs of Phenelzine a nurse must report?
Hypertensive crisis: severe occipital headache, palpitations, stiff neck, sweating, nausea - emergency, hold and report immediately. Serotonin syndrome with concurrent serotonergic drugs. Never combine with SSRIs/SNRIs/TCAs/meperidine or give without a 14-day washout. New or worsening suicidal thoughts.
What do I need to know about Phenelzine for the NCLEX?
Tyramine-rich foods (aged cheese, cured/smoked meats, fermented soy, draft beer, red wine, pickled/overripe foods) can cause hypertensive crisis. Combining with SSRIs, SNRIs, TCAs, meperidine, or sympathomimetics risks serotonin syndrome or hypertensive crisis. A 14-day washout is required between an MAOI and other serotonergic antidepressants (both directions). Effect on mood takes 2-4 weeks; orthostatic hypotension is a common early side effect.
What patient teaching is important for Phenelzine?
Strictly avoid tyramine-rich foods: aged cheese, cured/smoked/processed meats, fermented soy, draft beer, red wine, pickled or overripe foods. Do not take any OTC cold, cough, or decongestant products without provider approval. Report severe headache, palpitations, or neck stiffness immediately - it may be a hypertensive crisis. Change positions slowly to avoid dizziness from low blood pressure.
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Quick Tip
Tyramine-rich foods (aged cheese, cured/smoked meats, fermented soy, draft beer, red wine, pickled/overripe foods) can cause hypertensive crisis.