Eldepryl


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Related to Eldepryl: Zelapar

selegiline hydrochloride

Apo-Selegiline (CA), Dom-Selegiline (CA), Eldepryl, Emsam, Gen-Selegiline (CA), Novo-Selegiline (CA), Nu-Selegiline (CA), PMS-Selegiline, Zelapar

Pharmacologic class: MAO inhibitor (type B)

Therapeutic class: Antidyskinetic Pregnancy risk category C

Therapeutic class: Antidyskinetic Pregnancy risk category C

FDA Box Warning

• Drug may increase risk of suicidal thinking and behavior in children and adolescents with major depressive disorder (MDD) and other psychiatric disorders. Anyone considering using it for MDD in a child or adolescent must balance risk with clinical need, as depression itself increases suicide risk. With patient of any age, observe closely for clinical worsening, suicidality, and unusual behavior changes when therapy begins. Advise family and caregivers to observe patient closely and communicate with prescriber as needed.

• Drug isn't approved for use in pediatric patients.

Action

Unknown. Thought to increase dopaminergic activity by inhibiting MAO type B in nerve cells, increasing dopamine availability to brain cells.

Availability

Capsules: 5 mg

Tablets: 5 mg

Tablets (orally disintegrating): 1.25 mg

Transdermal system: 6 mg/24 hours, 9 mg/24 hours, 12 mg/24 hours

Indications and dosages

Adjunctive treatment of Parkinson's disease in patients who don't respond to carbidopa-levodopa alone

Adults: 10 mg P.O. daily in divided doses. After 2 to 3 days, attempt to reduce carbidopa-levodopa dosage (typically by 10% to 30%). Or initially, 1.25 mg (orally disintegrating tablets) P.O. daily for at least 6 weeks. May increase after 6 weeks to 2.5 mg P.O. daily based on effect and tolerability.

Major depressive disorder

Adults: Initially, apply 6 mg/24 hours patch; increase in dose increments of 2 mg/24 hours up to a maximum dose of 12 mg/24 hours at intervals of no less than two weeks, if needed.

Off-label uses

• Initial therapy for Parkinson's disease
• Alzheimer's disease
• Narcolepsy
• Adjunct in schizophrenia

Contraindications

• Hypersensitivity to drug or its components
• Concurrent meperidine therapy

Precautions

Use cautiously in:
• patients receiving tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SRRIs), or dextromethorphan, carbamazepine, and analgesics such as tramadol, methadone, and propoxyphene
• patients with pheochromocytoma
• elderly patients
• pregnant or breastfeeding patients
• children.

Administration

• Give orally disintegrating tablets in the morning before breakfast; don't give food or liquid 5 minutes before and after administration.
• Give capsules or regular tablets with breakfast and lunch, but restrict foods high in tyramine (such as aged cheese, red wine, yogurt, and smoked high-protein foods).

Don't give within 14 days of TCAs or SSRIs (5 weeks for fluoxetine because of its long half-life).
• Apply patch to dry, intact skin on the upper torso (below the neck and above the waist), upper thigh, or the outer surface of the upper arm once every 24 hours.

Adverse reactions

CNS: agitation, anxiety, bradykinesia, chorea, confusion, delusions, depression, dizziness, hallucinations, headache, dyskinesias, increased akinetic involuntary movements, insomnia, lethargy, light-headedness, loss of balance, syncope, vivid dreams

CV: orthostatic hypotension, hypertension, new or increased angina, palpitations, arrhythmias

GI: nausea, diarrhea, abdominal pain, dry mouth, buccal mucosa irritation (with orally disintegrating tablets)

GU: urinary retention

Musculoskeletal: leg pain, low back pain

Other: generalized aches, weight loss

Interactions

Drug-drug.Adrenergics: increased pressor response

Buspirone: elevated blood pressure

Dextromethorphan: brief episodes of psychosis or bizarre behavior

Levodopa: increased adverse reactions to levodopa

Meperidine and analgesics such as tramadol, methadone, and propoxyphene: stupor, muscle rigidity, severe agitation, fever, death

Other MAO inhibitors: hypertensive crisis

SSRIs, TCAs: severe mental status changes, CNS toxicity (with possible hyperpyrexia and death)

Drug-food.Tyramine-rich foods (such as aged cheese, red wine, yogurt, smoked high-protein foods): hypertensive crisis

Drug-herbs.Cacao: vasopressor effects

Ginseng: headache, tremor, mania

St. John's wort: life-threatening adverse reactions

Patient monitoring

• Monitor vital signs and cardiovascular status.
• Assess neurologic status and motor function. Institute safety measures as needed to prevent injury.
• Monitor weight and fluid intake and output.
• Monitor CBC and liver and kidney function tests.

Patient teaching

• Tell patient to take capsules or regular tablets with or without food, but he should avoid foods and beverages high in tyramine. Provide a list of these foods and beverages.
• Instruct patient (and caregiver as appropriate) to take orally disintegrating tablets in the morning before breakfast and not to push these tablets through the foil backing. Tell patient to peel back the backing of one or two blisters (as prescribed) with dry hands, gently remove the tablet, then immediately place the tablet on top of the tongue where it will disintegrate in seconds. Remind patient to avoid ingesting food or liquids for 5 minutes before and after taking orally disintegrating tablets.
• Inform patient to avoid tyramine-rich foods and beverages beginning on the first day of application of 9mg/24hours-or 12mg/24hours-patch and continue to avoid these foods and beverages for two weeks after a dose reduction to the 6mg/24hours-patch or following the discontinuation of the 9mg/24hours-or 12mg/24hours-patch.
• Instruct patient (and caregiver as appropriate) to monitor neurologic status and motor function and to institute safety precautions as needed to prevent injury.
• Instruct patient to move slowly when sitting up or standing, to avoid dizziness from sudden blood pressure decrease.
• Tell patient (or caregiver) that drug may cause serious interactions with many drugs. Instruct him to tell all prescribers he's taking it.
• Tell patient not to use St. John's wort without consulting with prescriber.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, foods, and herbs mentioned above.

Eldepryl

(ĕl′də-prəl)
A trademark for the drug selegiline hydrochloride.

deprenyl

Alternative pharmacology
A prescription drug used to treat Parkinson’s disease, which has acquired currency among some practitioners of alternative medicine as an anti-ageing substance; deprenyl acts on the substantia nigra., a region of the brain that is believed to age more rapidly than others, by blocking the degradation of dopaminergic neurotransmitters.

Eldepryl®

Deprenyl, see there.

Eldepryl

A brand name for SELEGILINE.
References in periodicals archive ?
will establish a new presence in China the area of women's oncology by marketing Fareston, and with the addition of Eldepryl, will further enhance its lineup of neurology products, which currently includes the anti-Alzheimer's agent Aricept(R) and the peripheral neuropathy treatment Methycobal(R), as it seeks to make further contributions to address the diversified needs of and increase the benefits provided to breast cancer and Parkinson's disease patients in China.
Whatever the eventual outcome of these studies, newly diagnosed and still-untreated persons with Parkinson's disease may be able to delay the onset of severe symptoms by using Eldepryl.
Goodman, who voted for approval with no dietary restrictions for the 20-mg dose, said he saw no signal of harmful effects of the 20-mg patch in clinical safety data presented by the manufacturer and in the more extensive database on Eldepryl.
Besides the conventional pharmaceutical regimen, which includes Eldepryl and dopamine-modulating drugs, one supplement that is helpful is called NADH (nicotinamide adenine dinucleotide), available at health-food stores under the brand name Enada; it comes in 5 to 10 mg tablets.
Artane, Kemadrin, Benadryl, Atkineton, Parlodel, Permax, Eldepryl Antianxiety and Hypnotic Agents - Librium, Valium, Dalmane,
In another study of oral Eldepryl for treating parkinsonism in 800 patients, with 2,970 patient years of exposure, mortality among those on selegiline (2.
Eldepryl, a monamine oxidase inhibitor, helps preserve motor control by slowing the breakdown of dopamine within the brain.
The oral formulation, marketed as Eldepryl, is approved as an adjunct to levodopa/carbidopa for treating people with Parkinson's disease.
Somerset"), which markets Eldepryl capsules for the treatment of Parkinson's disease, announced completion of its 48-week, 406 patient, Phase III multi- center clinical trial comparing its patented selegiline transdermal system (STS) with placebo therapy in patients with Alzheimer's disease.
1, 1997, CoCensys is no longer co-promoting the Novartis products but will continue to market Eldepryl and Cognex.
6% below last year's level due mainly to declining sales of the Company's selegiline based products, Eldepryl (R) and Novo-Selegiline partially offset by growth in Canadian dermatology revenues.