Indications
Selegiline is used to treat Parkinson’s disease, a condition that causes shaking, stiffness and slow movement. It can be used alone in early disease or together with Levodopa to smooth out the “wearing off” of Levodopa between doses.
How It Works
Parkinson’s disease is caused by a shortage of dopamine, a chemical messenger in the brain. Selegiline blocks an enzyme called monoamine oxidase B (MAO-B), which breaks dopamine down. This keeps dopamine active for longer and improves movement symptoms.
Dosage and Administration
The usual adult dose is 10 mg a day, taken either as a single dose in the morning or as 5 mg with breakfast and 5 mg with lunch, as prescribed. Avoid taking it later in the day, as it may cause difficulty sleeping. When added to Levodopa, the doctor may need to lower the Levodopa dose.
Interactions
Serious reactions (serotonin syndrome or dangerous rises in blood pressure) can occur with Pethidine, Tramadol, Methadone, Dextromethorphan, other MAO inhibitors, SSRI and SNRI antidepressants (such as Fluoxetine, Sertraline, Venlafaxine), tricyclic antidepressants, St John’s wort, Linezolid and decongestants such as Pseudoephedrine or Ephedrine. Do not start any new medicine, including cough and cold remedies, without checking with your doctor or pharmacist.
Contraindications
- Allergy to Selegiline.
- Use with Pethidine, Tramadol, other MAO inhibitors, SSRIs, SNRIs or Linezolid.
- Active stomach or duodenal ulcer.
- With Levodopa: severe high blood pressure, overactive thyroid, phaeochromocytoma, narrow-angle glaucoma, enlarged prostate with urine retention, severe angina or unstable heart rhythm.
Side Effects
Common effects include nausea, dry mouth, dizziness, trouble sleeping, headache, low blood pressure on standing, and, with Levodopa, increased involuntary movements, confusion or hallucinations. Mouth ulcers and raised liver enzymes may occur.
Get urgent medical help if you have a sudden severe headache, chest pain, a very fast heartbeat, high fever with stiffness, agitation and sweating, fainting, or signs of an allergic reaction.
Pregnancy and Lactation
There is not enough information on safety in pregnancy or breastfeeding. It is not recommended in these situations unless a doctor decides it is necessary.
Precautions and Warnings
Use with care in people with high blood pressure, heart rhythm problems, angina, psychosis, liver or kidney disease, or a history of ulcers. Some people develop impulse control problems such as gambling, overeating or compulsive shopping; tell your doctor if this happens. It may cause dizziness or sudden sleepiness, so take care when driving. Stop it at least 2 weeks before starting an antidepressant that interacts, and tell the anaesthetist before surgery.
Overdose
Overdose may cause agitation, severe headache, high or low blood pressure, fast heartbeat, fever, sweating, seizures and breathing problems. Seek emergency medical help immediately.
Therapeutic Class
Antiparkinson agent, monoamine oxidase B (MAO-B) inhibitor.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.