SELEGILINE

Indications & Dose:

Parkinson’s disease, used alone or as adjunct to cobeneldopa or co-careldopa to reduce ’end of dose’ deterioration Symptomatic parkinsonism

• BY MOUTH USING IMMEDIATE-RELEASE MEDICINES

Adult: Initially 5 mg once daily for 2–4 weeks, then increased if tolerated to 10 mg daily, dose to be taken in the morning

• BY MOUTH USING ORAL LYOPHILISATE

Adult: 1.25 mg once daily, dose to be taken before breakfast 

Contraindications:

Concurrent use with meperidine. 

Side Effects:

Cautions:

Precautions:

 Doses above 10 mg/day (doses in the 30-40 mg/day range are associated with nonselective monoamine oxidase inhibition) 

Interaction:

Drugs

Antidepressants, serotonin reuptake inhibitors (fluoxetine, fluvoxamine, paroxetine, sertraline):

Serious, sometimes fatal, reactions including hyperthermia, autonomic instability and mental status changes

Dexfenflhuramine: Severe hypertension

Guanadrel, guanethidone: May inhibit the antihypertensive effects of antihypertensive agents

Insulin: Excessive hypoglycemia may occur when MAOIs are administered to patients with diabetes

Levodopa: May precipitate hypertensive crisis

Methylphenidate: Increased risk of hypertensive reactions

Moclobemide: Increased pressor effects of tyramine; increased risk of adverse drug or food interactions

Narcotic analgesics (morphine): Stupor, muscular rigidity, severe agitation, elevated temperature, hallucinations, and death

Reseprine: Loss of antihypertensive effects Sibutramine: Increased risk of serotonin syndrome

Succinylcholine: Prolonged muscle relaxation caused by succinylcholine

Sympathomimetics (metaraminol, phenylpropanolamine, pseudoephedrine): Additive pressor response to Sympathomimetic

Sympathomimetics (norepinephrine, phenylephrine): additive pressor response to Sympathomimetic

Venlafaxine:Increased risk of serotonin syndrome 

Warnings:

Adverse Effects:

Lactations:

Pregnancy category C; excretion in breast milk unknown 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Anxiety, apathy, back and leg pain, blepharospasm, chorea, confusion, delusions, dizziness, dystonic symptoms, grimacing, hallucinations, headache, increased apraxia, increased bradykinesia, increased tremors, involuntary movements, lethargy, migraine, mood changes, muscle cramps, nightmares, numbness, overestimation, personality change, restlessness, sleep disturbances, tardive dyskinesia, tiredness, vertigo

CV: Angina pectoris, dysrhythmia, edema, hypertension, hypotension, orthostatic hypotension, palpitations, sinus bradycardia, syncope, tachycardia.

EENT: Blurred vision, diplopia, dry mouth, tinnitus

GI: Abdominal pain, anorexia, constipation, diarrhea, dysphagia, heartburn, nausea, poor appetite, rectal bleeding, vomiting, weight loss

GU: Frequency, hesitation, nocturia, prostatic hypertrophy, retention, sexual dysfunction, slow urination

RESP: Asthma, shortness of breath

SKIN: Alopecia, facial hair, hematoma, increased sweating, photosensitivity, rash

Patient And Carer Advice: