Selegiline

Brand names of selegiline

  • Apo-Selegiline
  • Carbex
  • Dom-Selegiline
  • Eldepryl
  • Gen-Selegiline
  • Novo-Selegiline
  • Nu-Selegiline
  • PMS-Selegiline

Selegiline is a part of the group of medicines known as phenethylamines and is basically derived from methamphetamine having a propargyl group bonded to a nitrogen atom. This medicament is employed to treat Parkinson's disease in its initial stage, senile dementia and depression. When used in standard clinical doses it works as a selective irreversible MAO-B inhibitor, while the drug loses its indication and also slows down the action of MAO-A when it is used in large dosages. While people being treated with MAOI generally have to follow several restrictions vis-à-vis their diet, such restrictions are not required when the medication is used in small doses. Moreover, it has been found that dietary restrictions are totally needless especially when selegiline is taken in normal doses, especially as Emsam - the variety that is applied as a patch to the skin (trans-dermal), because it does not result in any negative effects.

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Things you need to tell your physician before taking selegiline

Before you start therapy with selegiline, you must inform your physician as well as your pharmacist whether you have allergies to this drug or any additional medicaments. Notify your pharmacist, in addition to your physician, about all the prescriptions plus nonprescription drugs, dietary supplements, vitamins and herbal remedies you are using already.

You also need to tell your physician about all medications that you might have taken in the recent past, currently taking or intend to take in the near future, especially methadone (Dolophine), meperidine (Demerol), propoxyphene (Darvon), dextromethorphan (Robitussin), tramadol (Ultram, in Ultracet) as well as additional drugs that enclose selegiline (Emsam, Eldepryl, Zelapar). In case you are currently taking or have recently used any of the medicaments mentioned above, it is likely that your physician will advise you against taking selegiline. In case you discontinue selegiline, your physician will possibly tell you to stop taking the above mentioned drugs too for a minimum period of 14 days after you stop taking selegiline.

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Talk to your physician about your past and present ailments, especially kidney problems. Provided you are suffering from phenylketonuria (also known as PKU - a hereditary health condition wherein the patient has to take a special diet to avoid mental retardation), you ought to be familiar with the fact that selegiline orally dissolving tablets enclose phenylalanine.

Women who plan to take selegiline should let their physician know if they are expecting or planning to conceive. Women who have just given birth should tell their physician if they are breast feeding. Provided any woman conceives while taking selegiline, she should immediately call her physician for help and guidance.

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Before you start taking selegiline, you need to know that using this medicament may lead to nausea, dizziness and fainting when you stand up from a lying position very quickly. This happens more often during the initial stage of undergoing therapy with this drug. In order to prevent this from happening, try to arise from your bed slowly, first placing the feet for some time on the ground before you stand up.

Usage

Selegiline is used for treating Parkinson's disease in combination with carbidopa/ levodopa. This medication may also be used independently in the early stage of Parkinson's disease with a view to holdup the requirement of levodopa.

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How to use selegiline

Selegiline should be taken orally, normally two times every day - once with breakfast and then again with lunch. If you take this medication in the later part of the day, it may result in sleeping problems. The dose of this drug depends on the medical condition of the patient as well as his/ her response to treatment. Normally, the maximum dose of this medication is 5 mg taken twice every day. You should never enhance the dosage or take the medication more frequently than what your physician has instructed. When you have already been using selegiline for about two to three days, it is likely that your physician will simultaneously prescribe you a low dose of levodopa.

It is essential for people taking selegiline to strictly pursue their physician's instructions. It is not advisable to discontinue selegiline or alter the dosage of this drug or any other medication that you may be taking simultaneously without consulting your physician. You will have to wait for a few weeks before you experience the complete benefits of using selegiline. While you should not discontinue this drug abruptly, you should tell your physician if it does work as it has been or if your symptoms deteriorate further.

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Get in touch with your neighbourhood emergency room or poison control center right away in case you suspect that you have taken an overdose of the medication. It may be noted that the symptoms associated with an overdose of selegiline are unlikely to show till 12 hours after taking the medicament. The overdose symptoms may include restiveness, tetchiness, faintness, headache, debility, excitement, sweating, stupor, rapid heart rhythm, flushing, convulsions and confusion.

How selegiline works

When used in combination with carbidopa or levodopa, selegiline enhances the availability of carbidopa/ levodopa for use inside the body by means of impeding the actions of MAO (monoamine oxidase), an enzyme produced and secreted by the nervous system. This enzyme is present in the brain as well as the intestinal tract and works to disintegrate specific chemicals that have a function in commencing as well as regulating the muscle movements.

Side effects

Serious:
Common:
Less common:

Possible interactions

Herbal medicines or minerals:
Use caution while using St. John's wort, as its combination with selegiline may possibly result in serotonin syndrome. In addition, taking St. John's wort in conjunction with this medication is also likely to deteriorate photosensitivity. As ginseng partially acts like a MAO inhibitor, you should not use this combination too. You will also be better off if you keep away from using yohimbe and ma huang when you are being treated with selegiline. It is important to note that people having Parkinson's disease should never take calabar bean (for instance, ordeal nut, fabia, chop nuts and others), as it is hazardous when taken orally (owing to its active constituent called physostigmine). In addition, octacosanol (which is closely related to vitamin E) may further deteriorate problems related to movement and, therefore, people taking selegiline should stay away from it.
Foods:
If you are undergoing therapy with selegiline, you need to be cautious about consuming foods having tyramine. However, the interaction between selegiline and such foods is unlike to be as serious as that with other different drugs belonging to the class of MAO inhibitors.
Alcohol:
People taking selegiline should exercise caution while consuming alcoholic beverages till the combined consequences are ascertained. Use of alcohol by such people is likely to intensify the medication's sedative as well as blood pressure reducing effects. You should know that drinking aged wines or other alcoholic beverages containing tyramine may possibly result in reactions whose severity may vary.
Marijuana smoking:
People using selegiline should avoid smoking marijuana, as it may result in additive drowsiness.
Exposure to heat:
Exercise caution while coming in contact with heat unless you are certain about the consequences exposing yourself to heat while taking this medication. In fact, exposure to heat may lower the blood pressure of people using selegiline.
Exposure to sun:
People taking selegiline need to be careful while going out in the sun, because some patients using it have reported incidents of photosensitivity.

Discontinuation

It is not advisable to discontinue selegiline all of a sudden. If you stop taking this medication suddenly it may lead to an increase in the symptoms associated with Parkinson's disease and deteriorate your condition beyond control. Before you stop taking selegiline, it is necessary to check with your physician and discuss about a program for slowly decreasing the dose of the medication and simultaneously adjusting the dose of Sinemet or a different suitable medication.

Storage instructions

Always ensure that you keep selegiline in the same container in which it was sold. Close the container tightly and keep it away from children's reach. It is also important to keep this medicament at the usual room temperature. Do not store selegiline in your bathroom. Discard all medicaments that have become outdated or needed no more. Also discard all orally dissolving tablets that have not been used after three months of opening the protective package. If necessary, you may consult your pharmacist regarding the safe and appropriate way to dispose of such medications.

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