Buy Eldepryl Online

Selegiline (selegiline hydrochloride)

OTHER BRAND NAMES

Eldepryl

THERAPEUTIC CLASS

Monoamine oxidase inhibitor (MAOI) (type B)

DEA CLASS

RX

INDICATIONS

Adjunct in the management of parkinsonian patients being treated with levodopa/carbidopa who exhibit deterioration in the quality of their response to this therapy.

ADULT DOSAGE

Parkinson's Disease

Adjunct in the Management of Patients Being Treated w/ Levodopa/Carbidopa Who Exhibit Deterioration in the Quality of Response to this Therapy:

Usual: 10mg/day as divided doses of 5mg each taken at breakfast and lunch

After 2-3 days of therapy, may attempt to reduce levodopa/carbidopa dose; during continued therapy, further reductions of levodopa/carbidopa may be possible

ADMINISTRATION

Oral route

Take in divided doses at breakfast and lunch

HOW SUPPLIED

Tab: 5mg; (Eldepryl) Cap: 5mg

CONTRAINDICATIONS

Concomitant use with meperidine or other opioids.

WARNINGS/PRECAUTIONS

Do not use at doses >10mg/day due to risks associated with nonselective inhibition of MAO. Exacerbation of levodopa-associated side effects may occur; may mitigate effects by reducing levodopa/carbidopa dose by 10-30%. Observe closely for atypical responses. Patients with Parkinson's disease have a higher risk of developing melanoma; monitor for melanomas frequently and on a regular basis.

ADVERSE REACTIONS

Nausea, dizziness/lightheadedness/fainting, abdominal pain, confusion, hallucinations, dry mouth.

DRUG INTERACTIONS

See Contraindications. Avoid with SSRIs (eg, fluoxetine, sertraline, paroxetine) and TCAs (eg, amitriptyline, protriptyline); severe toxicity reported. At least 14 days should elapse between discontinuation of selegiline and initiation of TCAs or SSRIs. At least 5 weeks (longer with chronic/high-dose fluoxetine) should elapse between discontinuation of fluoxetine and initiation of selegiline due to long T1/2 of fluoxetine and its active metabolite. Hypertensive crises/reactions reported with ephedrine or tyramine-containing foods.

PREGNANCY AND LACTATION

Category C, caution in nursing.

MECHANISM OF ACTION

MAOI (Type B); not established. Irreversibly inhibits MAO type B (selectivity is dose-dependent), blocking the catabolism of dopamine. May also act through other mechanisms to increase dopaminergic activity.

PHARMACOKINETICS

Absorption: Cmax=1ng/mL. Metabolism: Extensive (presumably attributable to presystemic clearance in gut and liver); N-desmethylselegiline (active major metabolite), L-amphetamine and L-methamphetamine (major metabolites). Elimination: T1/2=2 hrs (single dose), 10 hrs (steady state).

ASSESSMENT

Assess for drug hypersensitivity, pregnancy/nursing status, and possible drug interactions.

MONITORING

Monitor for exacerbation of levodopa-associated side effects, atypical responses, and other adverse reactions. Monitor for melanomas frequently and on a regular basis.

PATIENT COUNSELING

Advise of the possible need to reduce levodopa dosage after initiation of therapy. Instruct not to exceed 10mg/day and explain the risk of using higher daily doses; provide a brief description of the 'cheese reaction.' Inform about the signs and symptoms associated with MAOI-induced hypertensive reactions; instruct to immediately report to physician any severe headache or other atypical/unusual symptoms not previously experienced. Instruct to inform physician if new or increased gambling urges, increased sexual urges, or other intense urges develop.

STORAGE

20-25°C (68-77°F).

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