nora-be and Atapryl Interactions

Interactions between nora-be(norethindrone) and Atapryl (selegiline)

norethindrone and selegiline (Moderate Drug-Drug)

MONITOR: The use of oral contraceptives or hormone replacement therapy may significantly increase selegiline bioavailability. In one study, the AUC of selegiline increased by 10 to 20-fold in subjects taking oral contraceptives. The proposed mechanism is inhibition of CYP450 3A hepatic metabolism. Increased concentrations of selegiline may result in loss of MAO-B selectivity and potentially severe adverse effects such as the serotonin syndrome.

MANAGEMENT: Monitoring for signs and symptoms of selegiline toxicity such as excessive MAO inhibition and hypertension when female sex steroids are added and monitoring for reduced selegiline effectiveness when steroids are withdrawn is recommended. Selegiline dosage and dietary adjustments (avoiding tyramine) may be required. Patients should be advised to notify their physician promptly if they experience symptoms such as severe headache, dizziness, nervousness, weakness, irritability, altered consciousness, seizures, confusion, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, or tachycardia.