Jaundice Associated with Administration of Iproniazid

Abstract

situation on the basis of the number of anginal attacks and the effort required to produce them. It should always be stopped before the patient returns to work.Because of the danger of masking myocardial ischaemia, the numerous side-effects, and the risk of serious liver damage, iproniazid is not indicated for the patient with mild angina.Although the drug could theoretically give rise to "silent infarction," this did not happen in any of our patients. Two of them had infarcts while receiving iproniazid. Both were at rest at the time and had typical pain.The side-effects of iproniazid are described by Robitzek and Selikoff (1952) Summary Iproniazid has been given to 40 patients with severe angina pectoris from occlusive coronary atherosclerosis, and was highly effective in reducing the frequency and severity of anginal attacks. It appears to act by blocking pain and not by improving the coronary circulation. Side-effects are common ; many of our patients complained of giddiness and two developed pulmonary oedema, presumably from fluid retention. The blocking of angina may encourage the patient to be more active and may precipitate infarction. Because of this and the side-effects, the drug is not indicated for patients with mild angina pectoris. In the patient with severe and intractable angina it is of great value, especially if anticoagulant therapy can be given in addition. The patient can often be helped over a prolonged ischaemic episode, the drug being withdrawn when the condition improves.We are grateful to Dr. Margaret Briggs, of Roche Products Limited, for her help and for supplies of marsilid.

Hepatic Necrosis Due to Marsilid

“…No case history could be found in the literature in which so small a dose of iproniazide caused a fatal result. Floody, Dixon, and Mattia (1958) state that the amount of iproniazide given to 13 fatal cases ranged from 300 to 8,000 mg. They give no details and most of the information seems to have been obtained from questionnaires.…”

“…They give no details and most of the information seems to have been obtained from questionnaires. Benaim and Dixon (1958) quote Marks as saying that jaundice may occur with as little as 25 mg. and that the duration of therapy is not important.…”

Exploration hépatique chez le tuberculeux pulmonaire par les méthodes enzymatiques. Recherche d’un éventual effet hépato-toxique des médicaments antibacillaires

“…C liniquem ent et biologiquem ent, la ressem blance est égalem ent étroite. D 'autres auteurs [7,44,83] ont ra p p o rté des cas sem blables oii l'a tte in te liépato-cellulaire é ta it au p re m ier plan.…”

Preliminary Observations on Cavodil in Treatment of Angina Pectoris

“…Senior Registrar From the University Department of Cardiology, Manchester Royal Infirmary Considerable success has been claimed for iproniazid in the treatment of angina pectoris (Cesarman, 1957;Cossio, 1957Cossio, , 1958Master, 1958;Towers and Wood, 1958). More recently, however, controlled trials have shown that the response to iproniazid may be little or no better than to a placebo (Dewar et al, 1959;Snow and Anderson, 1959).…”

“…More recently, however, controlled trials have shown that the response to iproniazid may be little or no better than to a placebo (Dewar et al, 1959;Snow and Anderson, 1959). Moreover, it has unpleasant and sometimes serious side-effects, particularly when used for prolonged periods (Robitzek and Selikoff, 1952;Master, 1958;Towers and Wood, 1958;Benaim and Dixon, 1958). Its most powerful known pharmacological action is the inhibition of monoamine oxidase, and it is thought that some or all of its clinical effects may be due to this. "…”