What is Manerix?

Manerix contains a medicine called moclobemide. This belongs to a group of medicines called ­antidepressants. Manerix is used to treat depression and social phobia. Manerix works by increasing the l­evels of important chemical messengers in your brain. This increase can help your depression or social phobia.

Always take Manerix exactly as your doctor has told you. You should check with your doctor if you are not sure.

Manerix is not suitable for children or adolescents. Take your tablets at the end of a meal. Swallow each tablet with a drink of water.

For depression the usual starting dose is 300 mg a day, split into two - three doses. The maximum dose is 600 mg a day.

For social phobia the usual starting dose is 150 mg twice a day for three days. Your doctor will increase the dose to 300 mg twice a day.

For people with severe liver disease, your doctor will decide the right dose for you. This will usually be lower than the doses stated above.

If you take more Manerix than you should or someone else takes your medicine by mistake, talk to a doctor or go to a hospital straight away.

Take the medicine pack with you. If you forget to take a dose, take it as soon as you remember. If it is nearly time for the next dose, skip the missed dose. Do not take a double dose to make up for a forgotten dose.

Even when you start to feel better, you should keep taking your tablets for as long as your doctor tells you to. Do not stop taking this medicine without t­ alking to your doctor first.
If you have any further questions on the use of this medicine, ask your d ­octor or pharmacist.

Do not take Manerix if:

• You are allergic to moclobemide or any of the other ­ingredients of this medicine.
• You have a severe mental problem which may make you confused, lose contact with reality or become un­able to think and judge clearly.
• You have a growth on one of your adrenal glands (phaeochromocytoma).
• You are taking or have recently stopped taking any other medicines to treat your depression or anxiety, such as fluoxetine, paroxetine or clomipramine.
• You are taking dextromethorphan, which is found in many cough medicines.
• You are taking pethidine (for pain ­relief).
• You are taking selegiline (for Par­kin­son’s disease). Children.
  
  

Manerix is not suitable for children or adolescents Do not take Manerix if any of the ­above applies to you. If you are not sure, talk to your doctor or pharmacist before ­taking Manerix. Take special care with Manerix.

Check with your doctor or pharmacist before taking Manerix if:

• You have a ‘bi-polar disorder’, sometimes call manic depression.
• You have ever thought about, or tried to harm or kill yourself.
• You have an overactive thyroid.
• You have serious liver disease. If any of the above apply to you, or if you are not sure, talk to your doctor or pharmacist ­before you take Manerix.

If you are depressed and/or have anxiety disorders you can sometimes have thoughts of harming or killing yourself. These may be increased when first starting antidepressants, since these medicines all take time to work, usually about two weeks but sometimes longer.
You may be more likely to think like this if:

• You have previously had thoughts about killing or harming yourself.
• You are a young adult.
  
  

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes m ­ edicines that you buy without a prescription and herbal medicines. This is because Manerix can affect the way some medicines work. Also some other medicines can affect the way Manerix works.
Do not take Manerix, and tell your doctor or pharmacist, if you are taking the following:

• Other medicines for your depression or anxiety, such as fluoxetine Bupropion, paroxetine or clomipramine.
• Dextromethorphan, which is found in many cough.
• Pethidine (for pain relief).
• Selegiline (for Parkinson’s disease).
• Triptans (for migraines)
• Tramadol (for pain relief)
• Linezolid (for the treatment of infections)
• St John‘s Wort (for anxiety)
• Cimetidine (used to treat stomach ulcers and acid indigestion or reflux).
• Ephedrine, pseudoephedrine and phenylpropanolamine, found in many cough and cold medicines.
• Morphine, Codeine or fentanyl (for pain relief).

Do not eat large quantities of foods con­taining tyramine when you are ­taking Manerix. These include: Mature cheese, yeast extract, fermented soya bean products.

Do not take Manerix if you are pregnant, trying to get pregnant or are breastfeeding, unless your doctor has told you to.

The medicine can affect your ability to drive as it may make you sleepy or dizzy. Do not drive while taking this medicine until you know how it affects you. Talk to your doctor or pharmacist if you are not sure whether it is safe for you to drive while taking this medicine.

This medicine contains lactose, which is a type of sugar. If you have been told by your doctor that you cannot tolerate or digest some sugars (have an intolerance to some sugars), talk to your doctor before taking this ­medicine.

Some side effects could be serious. If you have any of the side effects listed below, stop taking this medicine and seek urgent medical advice:

• welling of your throat, face, lips and mouth. This may make it difficult to breath or swallow.
• sudden swelling of your hands, feet or ankles.
• A raised, itchy skin rash (hives), itchy skin or flushing.

Other side effects include the following, if they get serious, please tell your doctor:

• Trouble sleeping
• Headache
• Feeling dizzy
• Dry mouth
• Feeling sick
• Feeling nervous, twitchy (restless), anxious or bad-tempered (irritable)
• Pins and needles or numbness of your hands and feet
• Low blood pressure (hypotension)
• Being sick
• Diarrhoea
• Constipation
• Thoughts about killing yourself
• Feeling confused and lost (disorientated)
• Loss of taste in your mouth
• Changes to your eyesight (vision)
• Swelling (fluid retention)
• Feeling weak or tired

Rare (affects 1 in 10,000 people):

• Loss of appetite
• Not enough sodium in your blood. Signs of this may be feeling sleepy, confused or having fits (seizures)
• Attempting to kill yourself Delusion
• Serotonin syndrome Signs of this may be High fever, irregular heartbeat, losing consciousness or having fits (seizures)

Q: What should I do I forget a dose?

A: If you forget to take a dose, take it as soon as you remember. If it is nearly time for the next dose, skip the missed dose. Do not take a double dose to make up for a forgotten dose.