In the U.S.—

In Canada—

Other commonly used names are deprenil; deprenyl.

• Antidyskinetic

Selegiline ( seh-LEDGE-ah-leen) is used in combination with levodopa or levodopa and carbidopa combination to treat Parkinson's disease, sometimes called shaking palsy or paralysis agitans. This medicine works to increase and extend the effects of levodopa, and may help to slow the progress of Parkinson's disease.

Selegiline is available only with your doctor's prescription, in the following dosage form:

Oral
• Capsules (U.S.)
• Tablets (U.S. and Canada)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For selegiline, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to selegiline. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Selegiline has not been studied in pregnant women. However, this medicine has not been shown to cause birth defects or other problems in animal studies.

Breast-feeding—It is not known whether selegiline passes into the breast milk.

Children—Studies on this medicine have been done only in adult patients and there is no specific information about its use in children. Therefore, be sure to discuss with your doctor the use of this medicine in children.

Older adults—In studies done to date that included elderly people, selegiline did not cause different side effects or problems in older people than it did in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases 2 different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking selegiline, it is especially important that your health care professional know if you are taking any of the following:

• Antidepressants, tricyclic (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Norpramin], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Pamelor], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil]) or
• Fluoxetine (e.g., Prozac) or
• Fluvoxamine (e.g., Luvox) or
• Meperidine (e.g., Demerol) or
• Nefazodone (e.g., Serzone) or
• Paroxetine (e.g., Paxil) or
• Sertraline (e.g., Zoloft) or
• Venlafaxine (e.g., Effexor)—Using these medicines together may increase the chance of serious side effects

• Stomach ulcer (history of)—Selegiline may make the condition worse

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Dosing—

The dose of selegiline will be different for different patients. Your doctor will determine the proper dose of selegiline for you. Follow your doctor's orders or the directions on the label.

For the treatment of Parkinson's disease, the usual dose of selegiline is 5 mg two times a day, taken with breakfast and lunch. Some patients may need less than this.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if you do not remember the missed dose until late afternoon or evening, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

When selegiline is taken at doses of 10 mg or less per day for the treatment of Parkinson's disease, there are no restrictions on food or beverages you eat or drink. However, the chance exists that dangerous reactions, such as sudden high blood pressure, may occur if doses higher than those used for Parkinson's disease are taken with certain foods, beverages, or other medicines. These foods, beverages, and medicines include:

• Foods that have a high tyramine content (most common in foods that are aged or fermented to increase their flavor), such as cheeses; fava or broad bean pods; yeast or meat extracts; smoked or pickled meat, poultry, or fish; fermented sausage (bologna, pepperoni, salami, summer sausage) or other fermented meat; sauerkraut; or any overripe fruit. If a list of these foods and beverages is not given to you, ask your health care professional to provide one.
• Alcoholic beverages or alcohol-free or reduced-alcohol beer and wine.
• Large amounts of caffeine-containing food or beverages such as coffee, tea, cola, or chocolate.
• Any other medicine unless approved or prescribed by your doctor. This especially includes nonprescription (over-the-counter [OTC]) medicine, such as that for colds (including nose drops or sprays), cough, asthma, hay fever, and appetite control; “keep awake” products; or products that make you sleepy.

Also, for at least 2 weeks after you stop taking this medicine, these foods, beverages, and other medicines may continue to react with selegiline if it was taken in doses higher than those usually used for Parkinson's disease.

Check with your doctor or hospital emergency room immediately if severe headache, stiff neck, chest pains, fast heartbeat, or nausea and vomiting occur while you are taking this medicine. These may be symptoms of a serious side effect that should have a doctor's attention.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.

Selegiline may cause dryness of the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

When you start taking selegiline in addition to levodopa or carbidopa and levodopa combination, you may experience an increase in side effects. If this occurs, your doctor may gradually reduce the amount of levodopa or carbidopa and levodopa combination you take.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Stop taking this medicine and get emergency help immediately if any of the following side effects occur:

• Symptoms of unusually high blood pressure (caused by reaction of higher than usual doses of selegiline with restricted foods or medicines)
  • Chest pain (severe);  enlarged pupils ;  fast or slow heartbeat;  headache (severe);  increased sensitivity of eyes to light;  increased sweating (possibly with fever or cold, clammy skin);  nausea and vomiting (severe) ;  stiff or sore neck 
  
  

Check with your doctor as soon as possible if any of the following side effects occur:

• More common
  • Increase in unusual movements of body;  mood or other mental changes 
  
  

• Less common or rare
  • Bloody or black, tarry stools;  difficult or frequent urination;  difficulty in breathing;  difficulty in speaking;  dizziness or lightheadedness, especially when getting up from a lying or sitting position ;  hallucinations (seeing, hearing, or feeling things that are not there);  irregular heartbeat;  lip smacking or puckering;  loss of balance control;  puffing of cheeks;  rapid or worm-like movements of tongue;  restlessness or desire to keep moving;  severe stomach pain;  swelling of feet or lower legs;  tightness in chest;  twisting movements of body;  uncontrolled chewing movements;  uncontrolled movements of face, neck, back, arms or legs;  vomiting of blood or material that looks like coffee grounds;  wheezing 
  
  

• Symptoms of overdose
  • Agitation or irritability;  chest pain ;  convulsions (seizures);  difficulty opening mouth or lockjaw;  dizziness (severe) or fainting;  fast or irregular pulse (continuing) ;  high fever;  high or low blood pressure;  increased sweating (possibly with fever or cold, clammy skin);  severe spasm where the head and heels are bent backward and the body arched forward;  troubled breathing 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• More common
  • Abdominal or stomach pain;  dizziness or feeling faint;  dryness of mouth;  nausea;  trouble in sleeping;  vomiting 
  
  

• Less common or rare
  • Anxiety;  back or leg pain;  blurred or double vision;  body ache ;  burning of lips, mouth, or throat;  chills;  constipation;  diarrhea;  drowsiness;  headache ;  heartburn;  high or low blood pressure;  inability to move;  frequent urge to urinate;  increased sensitivity of skin to light;  increased sweating;  irritability (temporary);  loss of appetite;  memory problems;  muscle cramps;  nervousness;  numbness of fingers or toes;  pounding or fast heartbeat;  red, raised, or itchy skin;  restlessness;  ringing or buzzing in ears;  slow or difficult urination;  slowed movements;  taste changes;  uncontrolled closing of eyelids;  unusual feeling of well-being;  unusual tiredness or weakness;  unusual weight loss 
  
  

• With doses higher than 10 mg a day
  • Clenching, gnashing, or grinding teeth;  sudden jerky movements of body 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.