Generic Name: selegiline (se-LE-ji-leen)
Brand Name: Eldepryl
Selegiline is used for:
Treating Parkinson disease in patients who are taking levodopa/carbidopa.
Selegiline is a monoamine oxidase inhibitor (MAOI). It works by prolonging the anti-Parkinson activity of levodopa, which may help to slow the progression of Parkinson disease. Selegiline has no anti-Parkinson effects of its own and must always be given in combination with levodopa/carbidopa.
Do NOT use selegiline if:
- you are allergic to any ingredient in selegiline
- you are taking fluoxetine or have taken it within the past 5 weeks
- you are taking bupropion, buspirone, cyclobenzaprine, dextromethorphan, meperidine, methadone, a norepinephrine reuptake inhibitor (eg, atomoxetine), propoxyphene, a selective serotonin reuptake inhibitor (SSRI) (eg, paroxetine), a serotonin-norepinephrine reuptake inhibitor (SNRI) (eg, duloxetine, venlafaxine), St. John's wort, a tetracyclic antidepressant (eg, mirtazapine), tramadol, or a tricyclic antidepressant (eg, amitriptyline). You will need to wait for a period of time after you stop these medicines before you start taking selegiline. If you have been taking one of these medicines, check with your doctor to see when you should start selegiline
- you are using another form of selegiline; another MAOI (eg, phenelzine); linezolid; a sympathomimetic, including an amphetamine, a cold product, or certain diet pills or preparations (eg, ephedrine, phenylephrine, phenylpropanolamine, pseudoephedrine); or sibutramine. You will need to wait for a period of time after you stop these medicines before you start taking selegiline. If you have been taking one of these medicines, check with your doctor to see when you should start selegiline
- you are taking a 5-HT 1 agonist (eg, sumatriptan), apraclonidine, carbamazepine, methylphenidate, oxcarbazepine, or nefazodone
- you will be undergoing elective surgery with general anesthesia or will be receiving cocaine or local anesthesia containing sympathomimetic vasoconstrictors
- you have certain adrenal gland problems (eg, pheochromocytoma)
Contact your doctor or health care provider right away if any of these apply to you.
Before using selegiline:
Some medical conditions may interact with selegiline. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a history of bipolar disorder, mania, mood or mental problems, suicidal thoughts or attempts, or uncontrolled muscle movements (eg, twitching of the face and tongue and involuntary movements of the arms and legs)
- if you have a history of ulcer, heart problems, recent heart attack, seizures, blood problems, or a metabolism disorder
- if you are taking a medicine that contains methylene blue
Some MEDICINES MAY INTERACT with selegiline. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Bupropion, cyclobenzaprine, dextromethorphan, linezolid, MAOIs (eg, phenelzine), meperidine, methadone, norepinephrine reuptake inhibitors (eg, atomoxetine), oral selegiline, propoxyphene, SNRIs (eg, duloxetine, venlafaxine), sibutramine, SSRIs (eg, fluoxetine. paroxetine), St. John's wort, sympathomimetics (eg, amphetamines, ephedrine, phenylephrine, phenylpropanolamine, pseudoephedrine), tetracyclic antidepressants (eg, mirtazapine), or tricyclic antidepressants (eg, amitriptyline) because a severe and sometimes fatal side effect called serotonin syndrome (eg, fever, muscle stiffness or rigidity, vital sign changes, mental or mood changes, coma) may occur
- Apraclonidine or buspirone because severe high blood pressure may occur
- Nefazodone or tryptophan because nausea, dizziness, mental or mood changes, seizures, fever, or breathing or heart problems may occur
- Tramadol because the risk of seizures may be increased
- Carbamazepine or oxcarbazepine because they may increase the risk of selegiline's side effects
- 5-HT1 agonists (eg, sumatriptan), insulin, meglitinide antidiabetics (eg, nateglinide), methylphenidate, or sulfonylureas (eg, glipizide) because the risk of their side effects may be increased by selegiline
This may not be a complete list of all interactions that may occur. Ask your health care provider if selegiline may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use selegiline:
Use selegiline as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take selegiline by mouth with food.
- Do NOT take more than the recommended dose without checking with your doctor.
- If your doctor tells you to stop taking selegiline, you will need to wait at least 14 days before beginning to take certain other medicines (eg, medicines for depression, anxiety, pain, cough, congestion, weight loss, or seizures; muscle relaxants). Ask your doctor if you are unsure when you should start to take your new medicines after you have stopped taking selegiline.
- Continue to take selegiline even if you feel well. Do not miss any doses.
- If you miss a dose of selegiline, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use selegiline.
Important safety information:
- Selegiline may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use selegiline with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Do not drink alcohol while you are using selegiline.
- Selegiline may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
- Do not suddenly stop using selegiline. The risk of side effects may be increased if selegiline is suddenly stopped. Check with your doctor before you change your dose or stop selegiline.
- Do not become overheated in hot weather or while you are being active; heatstroke may occur.
- Some people have experienced new, unusual, or increased urges (eg, gambling, sexual) while using selegiline. Tell your doctor right away if you notice such effects.
- Patients with Parkinson disease have an increased risk of developing a certain type of skin cancer (melanoma). It is not known if selegiline may contribute to the increased risk of melanoma. You may need to have skin exams while you are using selegiline. Discuss any questions or concerns with your doctor.
- Do not suddenly stop taking selegiline. Doing so may cause side effects similar to neuroleptic malignant syndrome (NMS). Symptoms may include fever; stiff muscles; confusion; abnormal thinking; fast or irregular heartbeat; and sweating. Contact your doctor at once if you have any of these symptoms. Check with your doctor before you change your dose or stop selegiline.
- Some patients who take selegiline have reported suddenly falling asleep while performing daily activities (eg, driving, eating, talking). Some patients did not experience drowsiness and felt that they were alert immediately before suddenly falling asleep. Some of these events have been reported as late as 1 year after selegiline was started. Use caution when driving, operating machinery, or performing other activities that could be dangerous. Inform your doctor if you experience unusual drowsiness or sleepiness while using selegiline.
- Eating foods high in tyramine (eg, aged cheeses, red wines, beer, certain meats and sausages, liver, sour cream, soy sauce, raisins, bananas, avocados) while you use an MAOI may cause severe high blood pressure. This could occur for up to 2 weeks after you stop taking an MAOI. Do not eat foods high in tyramine while you take selegiline. Ask your health care provider for a complete list of foods you should avoid. Seek medical attention at once if symptoms of severe high blood pressure occur. These may include severe headache, fast or irregular heartbeat, sore or stiff neck, nausea, vomiting, sweating, enlarged pupils, or sensitivity to light.
- Avoid dietary supplements containing tyramine or nonprescription products containing dextromethorphan, pseudoephedrine, or phenylephrine while you are using selegiline.
- Tell your doctor or dentist that you take selegiline before you receive any medical or dental care, emergency care, or surgery.
- You will need to check your blood pressure often. Talk with your doctor.
- Lab tests, including blood pressure and skin checks, may be performed while you use selegiline. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use selegiline with caution in the ELDERLY; they may be more sensitive to its effects.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using selegiline while you are pregnant. It is not known if selegiline is found in breast milk. If you are or will be breast-feeding while you use selegiline, check with your doctor. Discuss any possible risks to your baby.
Possible side effects of selegiline:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Dizziness; dry mouth; light-headedness; nausea; stomach pain; vivid dreams.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal thinking; changes in sexual ability or desire; chest pain; confusion; dark or unusual growths on the skin or any skin changes; enlarged pupils; fast, slow, or irregular heartbeat; fever; hallucinations; increased sweating; memory loss; nausea; neck stiffness or soreness; new or worsening agitation, aggressiveness, anxiety, depression, exaggerated feeling of well-being, hostility, impulsiveness, inability to sit still, irritability, panic attacks, or sleeplessness; rigid muscles; sensitivity to light; severe or persistent dizziness or headache; suicidal thought or actions; swelling of the arms or legs; tremor; unusual or intense urges (eg, gambling, sexual); vomiting.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.Proper storage of selegiline:
Store selegiline at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep selegiline out of the reach of children and away from pets.
- If you have any questions about selegiline, please talk with your doctor, pharmacist, or other health care provider.
- Selegiline is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take selegiline or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about selegiline. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to selegiline. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using selegiline.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.
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