Skip to main content

Emsam (selegiline) Disease Interactions

There are 11 disease interactions with Emsam (selegiline):

Major

Dopamine agonists (applies to Emsam) hypotension

Major Potential Hazard, Moderate plausibility.

Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension, especially during dose escalation. Therapy with dopamine agonists should be monitored carefully in patients with Parkinson's disease since they may have an impaired ability to respond to an orthostatic challenge, and also in patients receiving antihypertensive drugs.

References

  1. "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  3. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim, Ridgefield, CT.
  4. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
  5. Iwasaki S, Hamaguchi K, Iwasaki A, Takakusagi M, Narabayashi Y "Hypotensive effect of long-term levodopa in patients with Parkinson's disease." Eur Neurol 30 (1990): 194-9
  6. Hoehn MM "Levodopa-induced postural hypotension. Treatment with fludrocortisone." Arch Neurol 32 (1975): 50-1
View all 6 references
Major

Selegiline (applies to Emsam) major psychotic disorders

Major Potential Hazard, Moderate plausibility. Applicable conditions: Psychosis

Patients with major psychotic disorders should ordinarily not be treated with selegiline because of the risk of exacerbating psychosis.

Major

Selegiline (applies to Emsam) severe renal dysfunction

Major Potential Hazard, Moderate plausibility.

Small increments in serum BUN and creatinine have been observed in patients treated with high dose of selegiline. Treatment with selegiline is not recommended in patients with severe renal impairment and end-stage renal disease (CrCl <30 mL/min).

Moderate

Monoamine oxidase inhibitors (applies to Emsam) hypotension

Moderate Potential Hazard, Moderate plausibility.

Hypotension has been observed during therapy with monoamine oxidase inhibitors. These drugs should be used with caution, especially in patients with tendency towards hypotension or taking other drugs known to cause hypotension.

Moderate

Selegiline (applies to Emsam) cardiac disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Cardiovascular Disease

The use of selegiline has been associated with cardiovascular events such as tachycardia, bradycardia, syncope, hypertension, hypotension, arrhythmias, and aggravation of angina pectoris. Therapy with selegiline should be administered cautiously in patients with cardiac disease.

References

  1. "Product Information. Eldepryl (selegiline)." Somerset Pharmaceuticals Inc, Tampa, FL.
  2. Brodersen P, Philbert A, Gulliksen G, Stigard A "The effect of L-Deprenyl on on-off phenomena in Parkinson's disease." Acta Neurol Scand 71 (1985): 494-7
Moderate

Selegiline (applies to Emsam) glaucoma

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension

The use of selegiline may exacerbate glaucoma. Therapy with selegiline should be administered cautiously in patients with glaucoma.

References

  1. "Product Information. Eldepryl (selegiline)." Somerset Pharmaceuticals Inc, Tampa, FL.
Moderate

Selegiline (applies to Emsam) hypertension

Moderate Potential Hazard, Moderate plausibility.

Selegiline can cause hypertensive reactions and it should be used with caution in patients with hypertension. Patients should report any symptoms such as occipital headache, palpitations, neck stiffness or soreness, nausea, sweating, dilated pupils and photophobia. Patients receiving therapy need to have monitored their blood pressure frequently to detect any evidence of pressor response. Additionally, patients should be advised to avoid foods and drinks with high tyramine content such as cheese, sour cream, beer, liver, bananas and others, as these might trigger a hypertensive crisis.

Moderate

Selegiline (applies to Emsam) liver disease

Moderate Potential Hazard, Moderate plausibility.

Patients with mild to moderate hepatic impairment (Child-Pugh 5 to 9), may require a dose reduction of selegiline depending on their clinical response. Selegiline is not recommended in patients with severe hepatic impairment (Child-Pugh >9).

Moderate

Selegiline (applies to Emsam) melanoma

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Skin Cancer

Patients with Parkinson's disease have a higher risk of developing melanoma than the general population. Patients and providers should be advised to monitor for melanoma frequently and regularly when using selegiline. Skin examinations should be performed by qualified individuals (e.g., dermatologists).

Moderate

Selegiline (applies to Emsam) sleep disorders

Moderate Potential Hazard, Moderate plausibility.

Selegiline should be used with caution in patients with sleep disorders as it can cause somnolence. Patients should exercise caution when driving, operating machines, or working at heights during treatment. Treatment should be discontinued if patients develop daytime sleepiness with episodes of falling asleep during activities such as conversation, eating, etc. If not discontinued, patients should be very cautious about the activities that they engage in that could be potentially dangerous. Prescribers should question the patients specifically about somnolence, as it is rarely reported by patients, and ask about sleep disorders and the use of concomitant sedating medications.

Moderate

Selegiline (applies to Emsam) urinary retention

Moderate Potential Hazard, Moderate plausibility.

The use of selegiline may exacerbate urinary retention. Therapy with selegiline should be administered cautiously in patients with urinary retention or obstruction.

References

  1. "Product Information. Eldepryl (selegiline)." Somerset Pharmaceuticals Inc, Tampa, FL.

Emsam (selegiline) drug interactions

There are 498 drug interactions with Emsam (selegiline)

Emsam (selegiline) alcohol/food interactions

There are 3 alcohol/food interactions with Emsam (selegiline)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.