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Prescribing information for selegiline

Pooled analyses of short-term trials of antidepressant drugs SSRIs and others showed that these drugs increase the risk of suicidal thinking and behavior suicidality in children, adolescents, and young adults ages 18-24 with major depressive disorder MDD and other psychiatric disorders. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to in adults beyond age 24; there was a reduction with antidepressants compared to placebo in adults aged 65 and older. Metoclopramide. This may be manifest as symptoms consistent with serotonin syndrome or neuroleptic malignant syndrome.

Staff, The Pharma Letter

Contraceptives Estrogens: May increase the serum concentration of Selegiline. The decision to prescribe Anipryl should take into consideration that the MAO system of enzymes is complex and incompletely understood and there is only a limited amount of carefully documented clinical experience with selegiline. Consequently, the full spectrum of possible responses to selegiline may not have been observed in pre-marketing evaluation of the drug. It is advisable, therefore, to observe patients carefully for atypical responses. Selegiline capsules are usually taken twice a day, at breakfast and lunch. Follow your doctor's instructions.

Rinse until all soap is removed

To minimize dizziness and the risk of fainting, get up slowly when rising from a sitting or lying position. 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. No dosage adjustment necessary. Somerset Pharmaceuticals, Inc. Eldepryl selegiline hydrochloride capsules prescribing information. Tampa, FL; 1998 Jul.

Before taking selegiline

What are some of the physical signs that my dog is getting older? 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. RxList is part of the WebMD Health Network. The opinions expressed in the WebMD User Reviews are solely those of the User, who may or may not have medical or scientific training, and do not represent the opinions of WebMD. These member reviews have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other purpose except for compliance with our Terms and Conditions.



How should I use Emsam?

MPTP. 4 5 83 84 If an MPTP-like substance contributes to the pathogenesis of parkinsonian syndrome, the inhibition of oxidation of such a substance may protect against its neurotoxic effects. Do not drive while taking this medicine until you know how it affects you. Find patient medical information for selegiline oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. OXcarbazepine: May enhance the serotonergic effect of Selegiline. Rowland MJ, Bransome ED Jr, Hendry LB. Hypoglycemia caused by selegiline, an antiparkinsonian drug: can such side effects be predicted? The occurrence of stupor, muscular rigidity, severe agitation, and elevated temperature has been reported in some patients receiving the combination of Selegiline and meperidine. Symptoms usually resolve over days when the combination is discontinued. This is typical of the interaction of meperidine and MAOIs. Other serious reactions including severe agitation, hallucinations, and death have been reported in patients receiving this combination see . Severe toxicity has also been reported in patients receiving the combination of tricyclic antidepressants and Selegiline and selective serotonin reuptake inhibitors and Selegiline. See for details. N-Desmethylselegiline may have neuroprotective properties. A large multicenter study suggests a decrease in the disease progression of Parkinsonism but may have reflected other symptomatic response. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed See How to Use section. Some patients given selegiline may experience an of levodopa associated side effects, presumably due to the increased amounts of reaction with super sensitive, post-synaptic receptors.



General information about selegiline

What are the possible side effects of selegiline Eldepryl? Please refer to the for information on shortages of one or more of these preparations. EPINEPHrine Nasal: MAO Inhibitors may enhance the hypertensive effect of EPINEPHrine Nasal. Before having surgery, tell your doctor or dentist you are on this medication. You may need to stop using this drug beforehand. Follow your doctor's instructions carefully. Signs and symptoms of overdosage may include, alone or in combination, any of the following: drowsiness, dizziness, faintness, irritability, hyperactivity, agitation, severe headache, hallucinations, trismus, opisthotonus, convulsions, and coma; rapid and irregular pulse, hypertension, hypotension and vascular collapse; precordial pain, respiratory depression and failure, hyperpyrexia, diaphoresis, and cool, clammy skin. There are no adequate and well-controlled studies in pregnant women. EMSAM selegiline transdermal system should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Rajewski, Gregory; Ireland, Joyce 1996. "Absorption and presystemic metabolism of selegiline hydrochloride at different regions in the gastrointestinal tract in healthy males". Pharmaceutical Research. Fleeger CA, ed. USAN 1994: USAN and the USP dictionary of drug names. Rockville, MD: The United States Pharmacopeial Convention, Inc. You will need to check your blood pressure often. Talk with your doctor.



Indications and usage of selegiline

Accordingly, the first step in treating inappropriate elimination in any cat, regardless of age, is to take her to her veterinarian for a thorough examination. Pizotifen: MAO Inhibitors may enhance the anticholinergic effect of Pizotifen. Selective Serotonin Reuptake Inhibitors: MAO Inhibitors may enhance the serotonergic effect of Selective Serotonin Reuptake Inhibitors. This may cause serotonin syndrome. While methylene blue and linezolid are expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to monographs specific to those agents for details. The recommended for the administration of ELDEPRYL selegiline hcl is 10 mg per day administered as divided doses of 5 mg each taken at breakfast and lunch. There is no evidence that additional benefit will be obtained from the administration of higher doses. Moreover, higher doses should ordinarily be avoided because of the increased risk of side effects. Selegiline is best known as an irreversible inhibitor of monoamine oxidase MAO an intracellular enzyme associated with the outer membrane of mitochondria. Laboratory Tests: No specific laboratory tests are deemed essential for the management of patients on Anipryl, as response to therapy should be based on the history and physical examinations for both PDH and CDS. Distributed by: Zoetis Inc. Adderall or other medicines to treat attention deficit hyperactivity disorder ADHD. Anxious vocalizing is usually a plaintive howl or excessive whining. Store EMSAM selegiline transdermal system in its sealed pouch until use. There has been a long-standing concern, however, that antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment.



Common side effects of selegiline

Keep all medical and lab appointments. Doing this will make it easy for her to find everything she needs. Antidepressant discontinuation syndrome: Abrupt discontinuation or interruption of antidepressant therapy has been associated with a discontinuation syndrome. Symptoms arising may vary with antidepressant however commonly include nausea, vomiting, diarrhea, headaches, lightheadedness, dizziness, diminished appetite, sweating, chills, tremors, paresthesias, fatigue, somnolence, and sleep disturbances eg, vivid dreams, insomnia. Less common symptoms include electric shock-like sensations, cardiac arrhythmias more common with tricyclic antidepressants myalgias, parkinsonism, arthralgias, and balance difficulties. Selegiline in combination with the opioid analgesic is not recommended as it can lead to severe adverse effects. Dextromethorphan: MAO Inhibitors may enhance the serotonergic effect of Dextromethorphan. This may cause serotonin syndrome. Brimonidine Topical. MAO Inhibitors may increase the serum concentration of Brimonidine Topical. Prasad A, Glover V, Goodwin BL et al. Enhanced pressor sensitivity to oral tyramine challenge following high dose selegiline treatment. Psychopharmacology. John's wort; mirtazapine; and cyclobenzaprine. Sore mouth and swollen gums stomatitis. You can ask your pharmacist or doctor for information about EMSAM selegiline transdermal system that is written for health professionals. Mahmood I, Marinac JS, Willsie S et al. Pharmacokinetics and relative bioavailability of selegiline in healthy volunteers. Biopharm Drug Dispos.



Where can I get more information?

CYP2A6 may play a minor role in the metabolism. Many of the adverse effects in patients receiving selegiline plus levodopa result from increased dopaminergic activity and can be mitigated by reducing levodopa dosage; these effects include exacerbation of dyskinesias, confusion, and hallucinations. If your dog has become more fearful and anxious, he might begin vocalizing at things that scare or stress him, like noises or visitors. Showing your own frustration or punishing your dog for vocalizing can also increase his anxiety and aggravate the problem. Magyar K, Tóthfalusi L. Pharmacokinetic aspects of deprenyl effects. Pol J Pharmacol Pharm. Burke WJ, Ranno AE, Roccaforte WH et al. L-deprenyl in the treatment of mild dementia of the alzheimer type: preliminary results. J Am Geriatr Soc. What is selegiline Zelapar?



Selegiline consumer information

As with other MAOIs, postural hypotension, sometimes with orthostatic symptoms, can occur with EMSAM selegiline transdermal system therapy. Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. The clinical picture of MAOI overdose varies considerably; its severity may be a function of the amount of drug consumed. The central nervous and cardiovascular systems are prominently involved. Do not use a household spoon because you may not get the correct dose. The liquid forms and powder packets of this medication may contain aspartame. If you have phenylketonuria PKU or any other condition that requires you to restrict your intake of aspartame or consult your doctor or pharmacist about using this medication safely. Dose increases, in the elderly, should be made with caution and patients should be closely observed for postural changes in blood pressure throughout treatment. The information on this page is not a substitute for the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that a drug or drug combination is safe, effective or appropriate for any given patient. Drugs. Friedman RA, Leon AC 2007. Dista. Prozac fluoxetine hydrochloride prescribing information. If a patch falls off, try sticking it back into place. If it does not stick well, put on a new patch and leave it on only for the rest of your wearing time. Do not change your patch removal schedule. Discuss the risks and benefits with your doctor. Mahmood I, Peters DK, Mason WD: The pharmacokinetics and absolute bioavailability of selegiline in the dog.



Suicidal Thoughts or Actions

Brewer's or baker's yeast. Less interested in petting, interactions, greeting people or other dogs, etc. See: for details online. EPINEPHrine Oral Inhalation: MAO Inhibitors may enhance the hypertensive effect of EPINEPHrine Oral Inhalation. Ask your doctor or pharmacist for advice before taking any medicine. Apply immediately upon removal from the protective pouch. Selegiline can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Selegiline is contraindicated in patients less than 12 years of age because of an increased risk of hypertensive crisis. Do not stop taking selegiline suddenly or you may have harmful side effects. For best results, keep taking the medicine as prescribed. You may have thoughts about suicide when you first start using an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment. Kalir A, Sabbagh A, Youdim MBH.



About selegiline

Each pale yellow tablet is imprinted with a stylized “V”. Foods and drinks containing little to no tyramine are acceptable; the manufacturer product information should be consulted. Patients should be advised to use EMSAM selegiline transdermal system exactly as prescribed. Weeks 10 and 12. Do NOT take more than the recommended dose without checking with your doctor. Worsening and Suicide Risk. No studies have been conducted to evaluate the effects of race on the pharmacokinetics of ZELAPAR. Marcobal A, De las Rivas B, Landete J, et al. Tyramine and phenylethylamine biosynthesis by food bacteria. Crit Rev Food Sci Nutr. Milgram NW, Ivy GO, Murphy MP, et al: Effects of chronic oral administration of L-deprenyl in the dog. No clinically meaningful changes in ECG parameters from baseline to final visit were observed for patients in controlled studies. AB1, AB2, AB3, etc. Amphetamines: MAO Inhibitors may enhance the hypertensive effect of Amphetamines. While linezolid and tedizolid may interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to monographs specific to those agents for details.



Side effects of selegiline

Doxapram: MAO Inhibitors may enhance the hypertensive effect of Doxapram. Patients should be advised not to use sympathomimetic agents while on EMSAM selegiline transdermal system therapy. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip themissed dose and resume your usual dosing schedule. Your doctor will explain why this medicine has been chosen for you. 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. This drug is currently only licensed for use in dogs with cognitive dysfunction, but some behaviorists and veterinarians have reported improvement in cats as well. Treatment of overdose with non-selective MAO inhibitors is symptomatic and supportive. Domperidone. MAO Inhibitors may diminish the therapeutic effect of Domperidone. Domperidone may diminish the therapeutic effect of MAO Inhibitors. Antelman SM, Edwards DJ, Lin M. Phenethylamine: evidence for a direct, postsynaptic dopamine-receptor stimulating action. Brain Res. This medication must not be used in children younger than 12 years due to an increased risk of serious side effects such as extremely . Also, this medication is not recommended for use in children between 12 and 17 years old. Studies have not shown it to work in children in this age group. Lieberman, who is a neurology professor at the University of Miami.



ZELAPAR is taken in the fasted state

Read the Guide available from your before you start using selegiline and each time you get a refill. If you have any questions, consult your doctor or pharmacist. ZELAPAR or the effect of selegiline on other drugs. Sabelli HC, Javaid JI. Phenylethlyamine modulation of affect: therapeutic and diagnostic implications. Selegiline is an antidepressant monoamine oxidase inhibitor that treats depression by restoring the balance of certain natural substances neurotransmitters in the brain. Selegiline can improve your mood and feelings of well-being. This medication is a patch for use on the skin. Before using this medicine, tell your doctor if you have kidney disease, liver disease, heart disease, high or low blood pressure, or a seizure disorder. If you have any of these conditions, you may need a dose adjustment or special tests to safely take selegiline. Riederer P, Lachenmayer L November 2003. "Selegiline's neuroprotective capacity revisited". J Neural Transm. Selegiline is an L-methamphetamine with a group attached to the nitrogen atom. Many changes in behavior are signs of treatable medical disorders, and there are a variety of therapies that can comfort your cat and ease her symptoms, including any pain she might be experiencing. What should I discuss with my healthcare provider before using selegiline Zelapar? Naftopidil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. There may be new information. This information does not take the place of talking with your doctor about your medical condition or your treatment. Assessment of the carcinogenic potential of Selegiline in mice and rats is ongoing.



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Selegiline uses


Use is not recommended

This medicine has been prescribed for you. Do not pass it on to others. EMSAM selegiline transdermal system experienced a significantly longer time to relapse. ZELAPAR is taken in the fasted state. ZELAPAR-treated patients and 9% in placebo-treated patients. Ecstasy Paperback N. Saunders, London.

What other drugs will affect selegiline

Guaifenesin can affect the results of certain lab tests such as urine levels of certain acids. Make sure laboratory personnel and all your doctors know you use this drug. If no improvement is seen after 1 month at the higher dose or if at any time clinical signs progress, the dog should be re-evaluated. In dogs whose clinical signs of PDH progress despite Anipryl therapy in the absence of concurrent disease, alternate therapy should be considered. Selegiline is used together with other medicines to treat symptoms of Parkinson's disease.

Important information

Get emergency medical help if you have signs of an allergic reaction to Emsam: hives; difficult breathing; swelling of your face, lips, tongue, or throat. There are many other medicines that can cause serious medical problems if you take them together with selegiline. Tell your doctor about all other prescription and over-the-counter medications you use, including vitamins, minerals, and herbal products. Some medical conditions may interact with selegiline. Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents.

What are the possible side effects of selegiline

Use selegiline with caution regardless of the dosage. 1 See Interactions and also Advice to Patients. Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. MAOs are widely distributed throughout the body; their concentration is especially high in liver, kidney, stomach, intestinal wall, and brain. MAOs are currently subclassified into two types, A and B, which differ in their substrate specificity and tissue distribution.

If a patch becomes loose, press it back in place. If a patch falls off, apply a new one and go back to your regular schedule for patch changes. What happens if I overdose? MAO-B inhibition from steady state plasma levels. Take this by with or without food as directed by your doctor, usually once daily. Safety and efficacy not established. Dihydrocodeine: May enhance the serotonergic effect of MAO Inhibitors. This could result in serotonin syndrome.

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