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Posted by jedi on July 8, 2011, at 0:47:59
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » jedi, posted by europerep on July 7, 2011, at 11:35:11
> I do have one more question though: my pharmacist told me that I had to keep the phenelzine tablets in the fridge, between 2 and 8 degrees Celsius (36-46F). success with the same drug for me as well ;)..ER,
I've never kept my phenelzine from Pfizer and now Gavis in the fridge. Never was instructed to do so. Have had no problem with potency. I have read that one of the formulas from Europe or Australia had to be refrigerated. Not sure why.
Jedi
Posted by europerep on July 8, 2011, at 17:23:32
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » europerep, posted by jedi on July 8, 2011, at 0:47:59
> ER,
> I've never kept my phenelzine from Pfizer and now Gavis in the fridge. Never was instructed to do so. Have had no problem with potency. I have read that one of the formulas from Europe or Australia had to be refrigerated. Not sure why.
> Jedi
>Yeah, I've got the European version. In fact, I won't be taking "Nardil", but "Nardelzine", which is Pfizer's phenelzine brand over here, but I figured if I wrote I was going to take Nardelzine, noone would know what I'm talking about :)...
I'll try to keep the tabs cool whenever possible, but I guess they won't expire immediately when exposed to room temps.
The tabs smell funny by the way.. it's a typical pharmaceutical smell, but it does remind me a little bit of spray paint, which in turn reminds me of a relatively good time in my youth, so that's definitely already a positive for this drug ;). I hope other positives will add to it. I'll let you guys know how it works out after starting it on Monday..
Thanks for the help!
Bye,
ER
Posted by zonked on July 8, 2011, at 17:37:15
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » jedi, posted by europerep on July 8, 2011, at 17:23:32
Now I'm really curious - what is the imprint code on the tablets? Are they orange? American Pfizer/Greenstone tablets are orange and have a "PD 270" imprint. The smell I can only describe as being something between perfume and a skunk. We aren't told to keep ours in the fridge, I wonder if they're the same and we really SHOULD be keeping ours in the fridge? Gavis tablets are also orange but not nearly as smelly.
Posted by floatingbridge on July 9, 2011, at 9:08:34
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » jedi, posted by europerep on July 8, 2011, at 17:23:32
Posted by europerep on July 9, 2011, at 14:17:10
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » europerep, posted by zonked on July 8, 2011, at 17:37:15
> Now I'm really curious - what is the imprint code on the tablets? Are they orange? American Pfizer/Greenstone tablets are orange and have a "PD 270" imprint. The smell I can only describe as being something between perfume and a skunk. We aren't told to keep ours in the fridge, I wonder if they're the same and we really SHOULD be keeping ours in the fridge? Gavis tablets are also orange but not nearly as smelly.
Hehe, there's a couple of interesting things about these Nardelzine tablets. First, they come in a plastic bottle in which the tablets are loosely stored (the box rattles when you shake it). This is unusual for drugs here, usually they come in blisters with 10 or 14 tablets each, all of them individually sealed.
Then, after removing the seal and opening the bottle, it looks like the tablets are radioactive or something. They are colored in an extremely intense orange, you almost have to cover your eyes. (I exaggerate, but seriously, those pills have an extreme color.) The tablets look just like the phenelzine tablets that are at the bottom of the Wiki 'phenelzine' article, only that there is nothing imprinted on them on either side. Just the tablet.
Lastly, the smell.. I don't have them here right now so I can't describe it "live", but as I said it's amix between a pharmaceutical smell and the odor of spray paint. (Probably they have people sitting in the factory that spray them orange or something LOL.)
About the fridge thing:
Personally, I wonder whether it was once thought that phenelzine had to be stored in the fridge and they just didn't update it here. If it says nothing about keeping it in the fridge in the info that comes with the new generic Gavis version of phenelzine, then I doubt that it would be the other way around (i.e. that they only just discovered that phenelzine is unstable at temps above fridge level). So if I was you I wouldn't worry too much about it. Keeping them in the fridge probably doesn't hurt, but I don't think it's necessary for you. If it works for you, why change anything? (I will try to abide by the recommendation so as to rule out any possibility of the phenelzine deteriorating during the course of treatment.)So much for now. Bye,
ER
Posted by europerep on July 9, 2011, at 14:18:32
In reply to good luck er! (nm) » europerep, posted by floatingbridge on July 9, 2011, at 9:08:34
thank you! I will let you know how things go! I hope things are looking up for you, at least a little bit...
bye FB!...
ER
Posted by zonked on July 9, 2011, at 17:33:29
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » zonked, posted by europerep on July 9, 2011, at 14:17:10
Fascinating! As you may know, all our pills here come in bottles like that. I wonder if they are made go the same factory? The Pfizer/Greenstone bottles say "made in France". Might be a US government requirement that the dispensing bottles have this info-definitely a requirement that the pills have an imprint code. i notice that the top layer starts melting when the Pfizer/Greenstone tablets hit my tongue, something that doesn't happen with the Gavis. Anyway, good luck! I am crossing my fingers for you.
Posted by europerep on July 11, 2011, at 13:10:45
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » europerep, posted by zonked on July 9, 2011, at 17:33:29
I just came home and compared my tablets to the Nardil ones on wiki, and actually they are more different than I thought. The color of mine is pretty much like these shoes:
http://purchaze.com/en/290/reebok-freestyle-reign-bow-neon-orange.htmlAs I said, they look radioactive :)...
It's interesting though that the American Nardil tablets are made in France. My Nardelzines are made in the UK. The fact that Nardil is made in France raises another question for me though: unless they are being transported to the US in cooled containers (which is expensive!) I think it's likely that, during transport, they are exposed to temperatures above room temps, at least during summer. Think of containers standing in the sun, they'll get quite hot inside.
Another fun fact that I just found out:
Apparently there is a Nardil version being sold in the United Arab Emirates. I wonder what they look like.I'll probably start another thread on dosing info for phenelzine, I'd be happy about responses. :)
Posted by ger man on October 4, 2011, at 6:26:14
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » zonked, posted by europerep on July 11, 2011, at 13:10:45
> I just came home and compared my tablets to the Nardil ones on wiki, and actually they are more different than I thought. The color of mine is pretty much like these shoes:
> http://purchaze.com/en/290/reebok-freestyle-reign-bow-neon-orange.html
>
> As I said, they look radioactive :)...
>
> It's interesting though that the American Nardil tablets are made in France. My Nardelzines are made in the UK. The fact that Nardil is made in France raises another question for me though: unless they are being transported to the US in cooled containers (which is expensive!) I think it's likely that, during transport, they are exposed to temperatures above room temps, at least during summer. Think of containers standing in the sun, they'll get quite hot inside.
>
> Another fun fact that I just found out:
> Apparently there is a Nardil version being sold in the United Arab Emirates. I wonder what they look like.
>
> I'll probably start another thread on dosing info for phenelzine, I'd be happy about responses. :)The problem with cooling the tabs was very thrilling to me as im travelling around a lot. Im from europe (germany) too and first i got the uk generic version from archimedes (i think its the former concord version). When i got it they told me to store it at 2 to 8 degrees. When i heard that i told the pharmacist that it wont be possible for me to keep it under those controlled coditions so i asked the pharmacist to call archimedes pharm. if it is essential to keep it at those temperatures all the time and they said YES, just for a few hours its ok to have them at room temperature. Then i asked what to do an the pharmacist called the importer to find out if there are nardil versions that dont have to be stored in the fridge. they told to import the us version of pfizers nardil, i dont have them yet, but i will need them if i stay on it! I think it has something to do with the manufacturing process an mainly with the inactive ingredients. I could imagine that there are two places were nardil is made. the question why there are two original pfizer versions, one that has to be cooled (european) and the other that hasnt (US) remains unexplained to me!
Posted by europerep on October 6, 2011, at 14:09:37
In reply to Re: Questions on phenelzine/Nardil (@jedi and others), posted by ger man on October 4, 2011, at 6:26:14
I just saw this post of yours. I think you are definitely correct about Nardil/Nardelzine being made in (at least) two different places. Nardelzine is made by:
Recipharm Limited
Vale of Bardsley, Ashton-under-Lyne
Lancashire OL7 9RR (United Kingdom)It's great your pharmacist is helping you out so nicely with contacting the different pharma firms, distributors, etc. Personally, I have difficulty understanding why a drug whose active ingredient is not sensitive to higher temperatures has to be kept in the fridge, but I'm neither a pharmacist nor a chemist, so I'll defer to others regarding that question.
Anyhow, my Nardelzine tablets are still as glowing red and still smell the same way when I opened it first. Man these pills look awesome. ;) Just kidding...
I'm keeping my Nardelzines because I hope one day to get ahold of other phenelzine preparations, then I can make a photo for Wikipedia comparing the different Nardil products.
Anyhow, gotta watch the news now..
Bye!ER
Posted by Mark25 on November 10, 2011, at 10:09:55
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » ger man, posted by europerep on October 6, 2011, at 14:09:37
How did Nardil work out for you after Parnate / Jatrosom failed? Could you please tell me how the import procedure works? Thanks!
- Mark
Posted by Mark25 on November 10, 2011, at 10:11:38
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » ger man, posted by europerep on October 6, 2011, at 14:09:37
How did Nardil work out for you after Parnate / Jatrosom failed? Could you please tell me how the import procedure works? Thanks!
- Mark
Posted by Mark25 on November 12, 2011, at 12:12:21
In reply to Re: Questions on phenelzine/Nardil (@jedi and others), posted by Mark25 on November 10, 2011, at 10:11:38
Is it worth to give Nardil a shot altough Parnate didn't help me and caused really troublesome hypotension / dizziness? My major problem is social anxiety disorder, so the +GABAergic / calming action of Nardil could be better suited for that.
At the moment I take 8mg Klonopin a day as prescribed, but it doesn't make me want to socialize at all, just helps with the anxiety and in the end I'll have to taper down that stuff.
Nardil / Phenelzine isn't even available in my country, but as I live in the EU I should be able to import it from e.g. the UK with a valid (private) prescription I guess?
Posted by jedi on November 12, 2011, at 12:22:43
In reply to 2nd MAOI after the first one failed?, posted by Mark25 on November 12, 2011, at 12:12:21
> Is it worth to give Nardil a shot altough Parnate didn't help me and caused really troublesome hypotension / dizziness? My major problem is social anxiety disorder, so the +GABAergic / calming action of Nardil could be better suited for that.
>
> At the moment I take 8mg Klonopin a day as prescribed, but it doesn't make me want to socialize at all, just helps with the anxiety and in the end I'll have to taper down that stuff.
>
> Nardil / Phenelzine isn't even available in my country, but as I live in the EU I should be able to import it from e.g. the UK with a valid (private) prescription I guess?
Mark,
Nardil can and does work where Parnate fails. That is a S**tload of clonazepam! I used up to 5mg while I was waiting for Nardil to kick in the first time. Phenelzine is the "BOMB" for social anxiety and atypical depression. In my opinion it should be 2nd tier and not last resort for this diagnosis. It is a bloody crime that it is not available in your country. The stuff saved my life more than once! You can probably get all of the worthless SSRIs you want! Sorry! The MAOIs work where all others fail. I have been preaching about it on here for years. I did have 2 failed Parnate trials. Google some of my posts. This S**T works!
Good Luck,
Jedi
Posted by Mark25 on November 12, 2011, at 13:18:34
In reply to Re: 2nd MAOI after the first one failed? » Mark25, posted by jedi on November 12, 2011, at 12:22:43
> Mark,
> Nardil can and does work where Parnate fails. That is a S**tload of clonazepam! I used up to 5mg while I was waiting for Nardil to kick in the first time. Phenelzine is the "BOMB" for social anxiety and atypical depression. In my opinion it should be 2nd tier and not last resort for this diagnosis. It is a bloody crime that it is not available in your country. The stuff saved my life more than once! You can probably get all of the worthless SSRIs you want! Sorry! The MAOIs work where all others fail. I have been preaching about it on here for years. I did have 2 failed Parnate trials. Google some of my posts. This S**T works!
> Good Luck,
> JediThanks for you encouraging post! I know that's really much clonazepam, but less wouldn't do anything for me. Haven't taken it for too long without breaks (5 weeks).
I also have atypical depression since like 10+ years. Tried about 30 meds / combos, but to no avail.
My psychiatrist is cool and old-school, so getting a script for Nardil / phenelzine shouldn't be a problem. I don't know about import regulations, but guess - as the drug is approved in another EU country (UK) - it shouldn't be a problem. Other users from above were also able to get it. Insurance will very likely not pay for it, but that's OK.
PS: What's your Nardil dose?
- Mark
Posted by europerep on November 12, 2011, at 15:50:38
In reply to Re: 2nd MAOI after the first one failed?, posted by Mark25 on November 12, 2011, at 13:18:34
Hello there,
jedi knows more about that particular drug than I do, but it is generally accepted that, while tranylcypromine and phenelzine are both irreversible MAOIs, they do have their own pharmacological profile, so it's probably worth a try...
I was just going to say that, as a EU citizen, you shouldn't have too much trouble getting the drug even if it's not marketed in your particular country. There are two possiblities: what definitely works is take a prescription from your doctor to a pharmacy in a country where phenelzine is sold (UK, Belgium, Netherlands, Luxemburg, maybe others...). Per EU law, your prescription is valid in all 27 member countries.
In at least some countries, such as Germany, you can also have the drug imported by your pharmacy. I'm not familiar with how (and if) that procedure works in other member states though.
If you have more questions on that subject, let me know...
ER
Posted by Mark25 on November 12, 2011, at 16:34:05
In reply to Re: 2nd MAOI after the first one failed? » Mark25, posted by europerep on November 12, 2011, at 15:50:38
Thanks! Some bigger pharmacies here do import drugs from other EU countries.
I know that Parnate is considered more stimulating (altough I never felt that effect). And one metabolite of Nardil / Phenenlzine raises brain GABA levels which should make it more calming in general.
Could you please answer those short questions:
1) What shall my doctor write on the prescription (except the usual stuff)? The generic (english?) drug name or brand name?
Phenelzin(e) or Nardil or Nardelzine? I see Nardelzine is 15mg Phenelzine a 100 tablets, right? How much does it cost / did you pay?
Thanks in advance.
Posted by europerep on November 13, 2011, at 6:05:35
In reply to Re: 2nd MAOI after the first one failed?, posted by Mark25 on November 12, 2011, at 16:34:05
> Could you please answer those short questions:
>
> 1) What shall my doctor write on the prescription (except the usual stuff)? The generic (english?) drug name or brand name?
>
> Phenelzin(e) or Nardil or Nardelzine? I see Nardelzine is 15mg Phenelzine a 100 tablets, right? How much does it cost / did you pay?
>Hey there,
what your doctor should write on the prescription depends on what he wants to prescribe you. In the UK and the Netherlands, phenelzine is available as Nardil. In Belgium and Luxemburg it's Nardelzine.
I went to a Belgian pharmacy with my script that said "Nardelzine 100 tbl." and it worked fine. I'm not sure what the script has to say if you want to import a medicine, but I would assume that similar rules apply. If you want to be sure, go to a pharmacy near you and ask them about what your script must say in order to be valid.
When bought locally, Nardelzine costs around 34 per 100 tablets. When importing it, the price may be somewhat higher. I'm not sure about the price of Dutch or British Nardil. They all shouldn't be really expensive though, because phenelzine has been off-patent for a long, long time.
I hope that helps...
ER
Posted by jedi on November 13, 2011, at 8:01:07
In reply to Re: 2nd MAOI after the first one failed?, posted by Mark25 on November 12, 2011, at 13:18:34
> PS: What's your Nardil dose?
>Mark,
I'm currently off phenelzine. I've been off several times in the 13 years I have been taking the medication. This time I tapered down very slowly from 60mg. Took over 3 months. Right now, I'm only taking .5mg of clonazepam daily, on the way to zero.I'm a large male and the lowest effective dose for me is 60mg. 45mg does not provide the degree of MAO inhibition to knock back a major depression. I have been on 90mg for long periods. Even up to 120mg for a month or so. The side effects at 90mg are so much worse for me. I gained a lot of weight at first, but have taken most of that off. Watch for the hypomania when the med first kicks in. It hit me and many others on this board. It is not the true antidepressant effect, but it is very intoxicating, especially if you have been depressed for a long time. Don't chase the dragon!
I used to quote the 1mg/kg effective dosage that is published. If this was accurate, I would have to be on 120mg for the med to work. That is not the case for me. Everybody reacts to these medications differently. There are blood tests for MAO inhibition, but trial and error seems to be the way to judge. I have been on phenelzine enough that I can tell the dosage I need. I can feel the level of MAO inhibition in my body. It does take time to get there, but this drug is very predictable for me.
For me, there is also a synergism with phenelzine and clonazepam. They both effect GABA and this transmitter seems to be involved, to a high degree,in social anxiety and atypical depression.
Good luck my friend. Sounds like your symptoms and diagnosis are very similar to mine. I have been on 45+ different combinations of ADs and augmenters that did not work. Phenelzine can work when all others fail.
Jedi
Posted by ed_uk2010 on November 13, 2011, at 11:27:56
In reply to Re: 2nd MAOI after the first one failed? » Mark25, posted by europerep on November 13, 2011, at 6:05:35
>When bought locally, Nardelzine costs around 34 per 100 tablets. When importing it, the price may be somewhat higher. I'm not sure about the price of Dutch or British Nardil. They all shouldn't be really expensive though, because phenelzine has been off-patent for a long, long time.
If you had a private prescription for 100 Nardil tablets in the UK, it would cost about £25. This is about 30 euros.
If you were trying to import it from the UK it would probably be dramatically more expensive, especially since it is a fridge line.
Posted by Mark25 on November 14, 2011, at 9:18:13
In reply to Re: 2nd MAOI after the first one failed? » europerep, posted by ed_uk2010 on November 13, 2011, at 11:27:56
> If you had a private prescription for 100 Nardil tablets in the UK, it would cost about £25. This is about 30 euros.
>
> If you were trying to import it from the UK it would probably be dramatically more expensive, especially since it is a fridge line.
My local pharmacy asked their wholesaler and they can get me Nardelzine 100 tablets for 90 Euros.@jedi: I've read about the hypomania many feel at the beginning. Considering my body weight I plan to use 75-90mg for 8-10 weeks. That should be enough time to see if it works.
I'll tell you when I have started the treatment and keep you updated. Thanks for all answers.
Best wishes, Mark
Posted by ed_uk2010 on November 14, 2011, at 17:02:26
In reply to Re: 2nd MAOI after the first one failed?, posted by Mark25 on November 14, 2011, at 9:18:13
>If you had a private prescription for 100 Nardil tablets in the UK, it would cost about £25. This is about 30 euros.
> >
> > If you were trying to import it from the UK it would probably be dramatically more expensive, especially since it is a fridge line.
>
> My local pharmacy asked their wholesaler and they can get me Nardelzine 100 tablets for 90 Euros.That makes sense. If it is not marketed in your country, it will certainly be a lot more expensive.
>Considering my body weight I plan to use 75-90mg for 8-10 weeks. That should be enough time to see if it works.
I think it is unwise to decide on a 'target dose' before starting treatment. Response to psychiatric drugs is very individual. You will need to adjust the dose gradually based on how you *feel* (not how much you weigh). The correct dose is the lowest dose that provides adequate benefit and tolerable side effects.
Posted by europerep on November 16, 2011, at 8:46:23
In reply to Re: 2nd MAOI after the first one failed?, posted by Mark25 on November 14, 2011, at 9:18:13
> My local pharmacy asked their wholesaler and they can get me Nardelzine 100 tablets for 90 Euros.
>Hi there...
Depending on where you live in Europe, this may be a good deal or not. If you happen to live in say, Cologne, or Lille, it may be easier to just drive across the border and get Nardelzine in a Belgian pharmacy. If you don't live in one of the neighboring countries, then 90 euros is probably cheaper than if you went to buy it yourself.
Do you know if your insurance will cover the Nardelzine?
Posted by europerep on November 16, 2011, at 8:51:52
In reply to Re: 2nd MAOI after the first one failed? » europerep, posted by ed_uk2010 on November 13, 2011, at 11:27:56
> If you were trying to import it from the UK it would probably be dramatically more expensive, especially since it is a fridge line.
>Hey ed,
good to see you here again. You know, you are probably the one person here on the board who may have an answer to my question about the European Nardil/Nardelzine.
I don't understand why both the British Nardil and the Belgian Nardelzine (produced in the UK) are a fridge line, when the American Nardil isn't. That must mean that it's not actually the phenelzine that is sensitive to above-fridge temperatures, but something else that's in the tablets. I mean, even if the ingredients for the European versions are cheaper, that would most likely be offset by what it costs to have the products sit in a cooled warehouse, no? Do you have any idea why that is?
I'm just curious...
ER
Posted by pedr on November 16, 2011, at 9:12:11
In reply to Re: 2nd MAOI after the first one failed? » Mark25, posted by jedi on November 12, 2011, at 12:22:43
Hi,
I don't wish to hijack this thread but since we're talking about switching between MAOI's, can anyone tell me what wash-out period is required when changing from Nardil 45mg to Parnate? AFAIAA whilst they both inhibit MAO, they are chemically very different so my guess would be the recommended 2 week period.
And as a cheeky adjunct, does anyone have a "discontinuation rate" (e.g. decrease 15mg every week) for Nardil they'd recommend?
Thanks,
Pedr
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