Selegiline Medication: Uses, Dosage, and Side Effects Explained

Summary of Key Points

Selegiline is a medication commonly used to manage conditions such as Parkinson’s disease, major depressive disorder, and other neurological or psychiatric disorders. It works by increasing the levels of certain chemicals in the brain, particularly dopamine, which helps reduce symptoms. Selegiline is available in various forms and strengths. Always consult your healthcare provider before starting or adjusting your dose. You can also schedule a telemedicine consultation with one of our providers for personalized guidance.

Names of Selegiline Medication

US Brand Name: Eldepryl, Zelapar, Emsam (Selegiline)

The ‘generic name’ refers to the active ingredient in a medication, while the brand name is assigned by the manufacturer. In this case, Selegiline is the generic name.

Pharmacologic Category: MAO Inhibitors

Selegiline belongs to a class of medications known as Monoamine Oxidase Inhibitors (MAOIs), specifically a subtype called MAO-B inhibitors. This category of drugs is frequently used to treat Parkinson’s disease and depression.

Selegiline Dosage Guidelines

Selegiline is prescribed for various conditions. Below are the general dosing guidelines for adults. Always consult your healthcare provider before making any changes to your dose. You can also schedule a telemedicine visit with one of our providers for personalized advice.

Selegiline for Parkinson’s Disease

Oral tablets: 5 mg taken twice daily, typically with breakfast and lunch.

Orally disintegrating tablets: 1.25 mg once daily, taken before breakfast.

Selegiline for Depression Treatment

Transdermal patch: 6 mg/24 hours applied once daily. The dose may be increased to 9 mg/24 hours or 12 mg/24 hours depending on your response to treatment.

Off-Label Selegiline Uses

Selegiline is sometimes prescribed for conditions other than Parkinson’s disease and depression. Below are some off-label uses. Always consult your healthcare provider for specific recommendations.

1. Alzheimer’s Disease and Dementia: 5-10 mg daily
2. Attention Deficit Hyperactivity Disorder (ADHD): 5-10 mg daily
3. Narcolepsy: 5-10 mg daily
4. Restless Legs Syndrome: 5-10 mg daily
5. Schizophrenia: 5-10 mg daily
6. Anxiety Disorders: 5-10 mg daily
7. Chronic Pain: 5-10 mg daily

Selegiline Dosage Forms and Strengths

Selegiline is available in different forms and strengths to accommodate various treatment needs. Below are the available options:

1. Oral tablet: 5 mg
2. Orally disintegrating tablet: 1.25 mg
3. Transdermal patch: 6 mg/24 hours, 9 mg/24 hours, 12 mg/24 hours

Administration Instructions for Selegiline

Selegiline should be taken exactly as prescribed by your healthcare provider. Follow these guidelines for proper administration:

1. Oral tablets: Take with food, typically with breakfast and lunch.
2. Orally disintegrating tablets: Place the tablet on your tongue and allow it to dissolve without water.
3. Transdermal patch: Apply to clean, dry skin and replace every 24 hours. Avoid cutting or tearing the patch.

If you have any questions about how to take Selegiline, consult your healthcare provider or schedule a telemedicine visit with one of our providers.

Contraindications for Selegiline

A contraindication is a specific situation where a drug should not be used because it may be harmful. If you have any of the conditions listed below, you should not take Selegiline, or you should discuss it thoroughly with your healthcare provider before starting treatment.

1. Allergy to Selegiline: If you have a known allergy to Selegiline or any of its ingredients, taking the medication could cause a severe allergic reaction, including difficulty breathing, swelling, or rash.
2. Use of other MAO inhibitors: Selegiline is a type of monoamine oxidase inhibitor (MAOI). Taking it with other MAOIs (such as phenelzine or tranylcypromine) can lead to dangerously high serotonin levels, causing a life-threatening condition called serotonin syndrome.
3. Severe liver disease: Selegiline is metabolized by the liver. If you have severe liver disease, your body may not process the medication properly, leading to harmful side effects or toxicity.
4. Uncontrolled hypertension (high blood pressure): Selegiline can increase blood pressure. If you already have uncontrolled hypertension, taking Selegiline could raise your blood pressure to dangerous levels, increasing the risk of stroke or heart attack.
5. Use of certain antidepressants: Taking Selegiline with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) can increase the risk of serotonin syndrome. Examples include fluoxetine (Prozac) and venlafaxine (Effexor).

Selegiline Drug Interactions

Selegiline can interact with several medications, which may increase the risk of side effects or reduce the effectiveness of your treatment. Always inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Below are some common medications that may interact with Selegiline:

1. Antidepressants: Fluoxetine (Prozac), sertraline (Zoloft), duloxetine (Cymbalta), venlafaxine (Effexor)
2. Opioid pain medications: Meperidine (Demerol), tramadol (Ultram), methadone (Methadose)
3. Stimulants: Amphetamine (Adderall), methylphenidate (Ritalin)
4. Other MAO inhibitors: Phenelzine (Nardil), tranylcypromine (Parnate)
5. Over-the-counter cold medications: Pseudoephedrine (Sudafed), phenylephrine (Sudafed PE)

Selegiline in Pregnancy

Is it safe to take Selegiline during pregnancy?

There is limited information regarding the safety of Selegiline during pregnancy. While animal studies suggest potential risks to the fetus, no well-controlled studies have been conducted in pregnant women. If you are pregnant or planning to become pregnant, it is essential to discuss the potential risks and benefits of Selegiline with your healthcare provider. They can help you carefully weigh the potential impact on your baby against the benefits of managing your condition.

Selegiline while Breastfeeding

Is it safe to take Selegiline while breastfeeding?

There is not enough information to determine whether Selegiline passes into breast milk or if it could affect a nursing infant. If you are breastfeeding or planning to breastfeed, consult your healthcare provider before starting Selegiline. They will help you assess whether the benefits of taking the medication outweigh any potential risks to your baby.

Estimated Cost of Selegiline Medication

The cost of a 30-day supply of Selegiline can vary depending on the pharmacy and your location. Without insurance, using a GoodRx coupon, the estimated price for a 30-day supply of Selegiline (5 mg tablets) typically ranges from $20 to $50. Prices may fluctuate, so it’s a good idea to check with your local pharmacy or use a coupon service like GoodRx to find the most affordable option.

Possible Alternatives to Selegiline

If Selegiline is not the right medication for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to explore these alternatives further.

Parkinson’s Disease

Other Parkinson’s medications include levodopa/carbidopa (Sinemet) or dopamine agonists such as pramipexole (Mirapex). Physical therapy and regular exercise can also help improve mobility and reduce symptoms.

Major Depressive Disorder

Alternative antidepressants, such as SSRIs (e.g., sertraline) or SNRIs (e.g., venlafaxine), may be considered. Cognitive-behavioral therapy (CBT) and lifestyle changes, including regular exercise and a balanced diet, can also be beneficial. While Selegiline may be an option for some patients with depression, it’s important to discuss all alternatives with your healthcare provider.

Alzheimer’s Disease

Commonly prescribed medications include donepezil (Aricept) or memantine (Namenda). Cognitive stimulation and maintaining social engagement can also help slow cognitive decline. Although Selegiline is being researched for Alzheimer’s disease, other treatments are more frequently recommended.

Dementia

Similar to Alzheimer’s disease, medications like donepezil or rivastigmine (Exelon) may be used. Non-drug approaches, such as establishing a structured routine and ensuring a safe environment, are also important in managing symptoms.

Attention Deficit Hyperactivity Disorder (ADHD)

Stimulants like methylphenidate (Ritalin) or non-stimulants like atomoxetine (Strattera) are common alternatives. Behavioral therapy and organizational strategies can also help manage symptoms. While Selegiline is being explored in some studies for ADHD, it is not considered a first-line treatment.

Narcolepsy

Medications such as modafinil (Provigil) or sodium oxybate (Xyrem) may be prescribed. Maintaining a consistent sleep schedule and practicing good sleep hygiene can also help improve symptoms.

Restless Legs Syndrome

Dopamine agonists like ropinirole (Requip) or gabapentin (Neurontin) are often used. Lifestyle changes, such as reducing caffeine and alcohol intake, can also help manage symptoms.

Schizophrenia

Antipsychotic medications like risperidone (Risperdal) or aripiprazole (Abilify) are common alternatives. Psychotherapy and social support are also key components of treatment.

Anxiety Disorders

SSRIs such as escitalopram (Lexapro) or benzodiazepines like lorazepam (Ativan) may be prescribed. Cognitive-behavioral therapy (CBT) and mindfulness practices can also be effective in managing anxiety.

Chronic Pain

Alternatives include medications like gabapentin (Neurontin) or duloxetine (Cymbalta). Physical therapy, acupuncture, and lifestyle changes, such as regular exercise, may also help manage chronic pain.

Recent Updates on Selegiline Research

Recent studies have explored the potential neuroprotective effects of Selegiline, particularly in Parkinson’s disease and Alzheimer’s disease. Some research suggests that Selegiline may help slow the progression of neurodegenerative diseases by reducing oxidative stress and inflammation in the brain. However, more clinical trials are needed to confirm these findings. Additionally, ongoing studies are investigating the use of Selegiline for treating depression and ADHD, with promising early results. As research continues, new insights into the broader applications of Selegiline may emerge.

James Kingsley

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