Deprenyl; L-Deprenyl; Selegiline Hydrochloride|
Antidepressant, Monoamine Oxidase Inhibitor; Anti-Parkinson's Agent (Monoamine
Adjunct in the management of parkinsonian patients in which
levodopa/carbidopa therapy is deteriorating
Hypersensitivity to selegiline; concomitant use of
Increased risk of nonselective MAO inhibition occurs with doses >10
mg/day; it is a monoamine oxidase inhibitor type "B", there should not be a
problem with tyramine-containing products as long as the typical doses are
employed, however, rare reactions have been reported. Use with tricyclic
antidepressants and SSRIs has also been associated with rare reactions and
should generally be avoided. Addition to levodopa therapy may result in
exacerbation of levodopa adverse effects, requiring a reduction in levodopa
Cardiovascular: Orthostatic hypotension, hypertension, arrhythmias,
palpitations, angina, tachycardia, peripheral edema, bradycardia, syncope
Central nervous system: Hallucinations, dizziness, confusion, anxiety,
depression, drowsiness, behavior/mood changes, dreams/nightmares, fatigue,
Dermatologic: Rash, photosensitivity
Gastrointestinal: Xerostomia, nausea, vomiting, constipation, weight loss,
anorexia, diarrhea, heartburn
Genitourinary: Nocturia, prostatic hypertrophy, urinary retention, sexual
Neuromuscular & skeletal: Tremor, chorea, loss of balance, restlessness,
Ocular: Blepharospasm, blurred vision
Miscellaneous: Diaphoresis (increased)
Symptoms of overdose include tachycardia, palpitations, muscle twitching,
Competent supportive care is the most important treatment; both hypertension
or hypotension can occur with intoxication. Hypotension may respond to I.V.
fluids or vasopressors, and hypertension usually responds to an alpha-adrenergic
blocker. While treating the hypertension, care is warranted to avoid sudden
drops in blood pressure, since this may worsen the MAO inhibitor toxicity.
Muscle irritability and seizures often respond to diazepam, while hyperthermia
is best treated antipyretics and cooling blankets. Cardiac arrhythmias are best
treated with phenytoin or procainamide.
CYP2D6 enzyme substrate
Concurrent use of selegiline with an SSRI may result in mania or
hypertension; it is generally best to avoid these combinations
Selegiline (>10 mg/day) in combination with tyramine (cheese, ethanol) may
increase the pressor response; avoid high tyramine-containing foods in patients
receiving >10 mg/day of selegiline
Potent monoamine oxidase (MAO) type-B inhibitor; MAO-B plays a major role in
the metabolism of dopamine; selegiline may also increase dopaminergic activity
by interfering with dopamine reuptake at the synapse
Onset of therapeutic effects: Within 1 hour
Duration: 24-72 hours
Half-life: 9 minutes
Metabolism: In the liver to amphetamine and methamphetamine
Elderly: Initial: 5 mg in the morning, may increase to a total of 10 mg/day
This medication may cause sudden and severe high blood pressure when taken
with food high in tyramine (cheeses, sour cream, yogurt, pickled herring,
chicken liver, canned figs, raisins, bananas, avocados, soy sauce, broad bean
pods, yeast extracts, meats prepared with tenderizers, and many foods aged to
improve flavor; wine (Chianti and hearty red) and beer); small amounts of
caffeine may produce irregular heartbeat or high blood pressure and can interact
with this medication for up to 2 weeks after stopping its
Blood pressure, symptoms of parkinsonism
|Dental Health: Local
Selegiline in doses of 10 mg a day or less does not inhibit type-A MAO.
Therefore, there are no precautions with the use of
Effects on Dental Treatment|
>10% of patients experience dry mouth; anticholinergic side effects can
cause a reduction of saliva production or secretion contributing to discomfort
and dental disease (ie, caries, oral candidiasis and periodontal
Take exactly as directed (may be prescribed in conjunction with
levodopa/carbidopa); do not change dosage or discontinue without consulting
prescriber. Therapeutic effects may take several weeks or months to achieve and
you may need frequent monitoring during first weeks of therapy. Take with meals
if GI upset occurs, before meals if dry mouth occurs, after eating if drooling
or if nausea occurs. Take at the same time each day. Avoid tyramine-containing
foods (low potential for reaction). Maintain adequate hydration (2-3 L/day of
fluids unless instructed to restrict fluid intake); void before taking
medication. Do not use alcohol and prescription or OTC sedatives or CNS
depressants without consulting prescriber. You may experience drowsiness,
dizziness, confusion, or vision changes (use caution when driving, climbing
stairs, or engaging in tasks requiring alertness until response to drug is
known); orthostatic hypotension (use caution when changing position - rising to
standing from sitting or lying); constipation (increased exercise, fluids, or
dietary fruit and fiber may help); runny nose or flu-like symptoms (consult
prescriber for appropriate relief); nausea, vomiting, loss of appetite, or
stomach discomfort (small frequent meals, frequent mouth care, chewing gum, or
sucking lozenges may help). Report unresolved constipation or vomiting; chest
pain, palpitations, irregular heartbeat; CNS changes (hallucination, loss of
memory, seizures, acute headache, nervousness, etc); painful or difficult
urination; increased muscle spasticity, rigidity, or involuntary movements; skin
rash; or significant worsening of condition. Pregnancy/breast-feeding
precautions: Inform prescriber if you are or intend to be pregnant. Consult
prescriber if breast-feeding.
Monoamine oxidase inhibitor type "B"; there should not be a problem
with tyramine-containing products as long as the typical doses are
Capsule, as hydrochloride (Eldepryl®): 5 mg
Tablet: 5 mg
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