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Eldepryl (Selegiline) is the only anti-Parkinson's agent that has been found to slow the loss of dopamine. Selegiline works to control Sinemet dose increases and maintain your ability to function over time. By keeping your Sinemet dose lower, Selegiline will help to minimize Sinemet-related side effects and prolong the duration of Sinemet effectiveness. Sinemet or Sinemet CR is prescribed to provide rapid relief of Parkinson's disease symptoms. It does this by delivering levodopa to the bloodstream which is then changed to dopamine in the brain.

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Uses

Selegiline is indicated as an adjunct in the management of Parkinsonian patients being treated with levodopa/carbidopa who exhibit deterioration in the quality of their response to this therapy. There is no evidence from controlled studies that selegiline has any beneficial effect in the absence of concurrent levodopa therapy.
Evidence supporting this claim was obtained in randomized controlled clinical investigations that compared the effects of added selegiline or placebo in patients receiving levodopa/carbidopa. Selegiline was significantly superior to placebo on all three principal outcome measures employed: change from baseline in daily levodopa/carbidopa dose, the amount of 'off' time and patient self-rating of treatment success. Beneficial effects were also observed on other measures of treatment success (e.g., measures of reduced end of dose akinesia, decreased tremor and sialorrhea, improved speech and dressing ability and improved overall disability as assessed by walking and comparison to previous state).

How to take

Take the right dose of each medication on the schedule your doctor provided you. Tampering with this plan on your own can set you back-do not risk it.

Side effects

All medications are associated with side effects. You may experience some side effects with the drugs prescribed by your health care professional for your Parkinson's disease. You should note these events and discuss these with your health care professional as soon as possible. By knowing your responses to the prescribed medications, your health care professional will be able to counsel you and tailor your regime to maximize safety and efficacy.

Precaution

Some patients given selegiline may experience an exacerbation of levodopa-associated side effects, presumably due to the increased amounts of dopamine reaction with super sensitive, post-synaptic receptors. These effects may often be mitigated by reducing the dose of levodopa/carbidopa by approximately 10 to 30%.
The decision to prescribe selegiline should take into consideration that the MAO system of enzymes is complex and incompletely understood and there is only a limited amount of carefully documented clinical experience with selegiline. Consequently, the full spectrum of possible responses to selegiline may not have been observed in pre-marketing evaluation of the drug. It is advisable, therefore, to observe patients closely for atypical responses.

Drug interactions

The occurrence of stupor, muscular rigidity, severe agitation, and elevated temperature has been reported in some patients receiving the combination of selegiline and meperidine. Symptoms usually resolve over days when the combination is discontinued. This is typical of the interaction of meperidine and MAOIs. Other serious reactions (including severe agitation, hallucinations, and death) have been reported in patients receiving this combination (see CONTRAINDICATIONS). Severe toxicity has also been reported in patients receiving the combination of tricyclic antidepressants and selegiline and selective serotonin reuptake inhibitors and selegiline. (See WARNINGS for details.) One case of hypertensive crisis has been reported in a patient taking the recommended doses of selegiline and a sympathomimetic medication (ephedrine).

Missed dose

If you miss a dose, take as soon as remembered; do not take if it is almost time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

Storage

Store at room temperature between 59 and 86 degrees F (between 15 and 30 degrees C) away from moisture and sunlight. Do not store in the bathroom. Keep away from children and pets.