Selegiline

Indications

Selegiline is used for: Parkinson Diseas

Adult Dose

Oral Early parkinsonism Adult: As conventional preparation: 10 mg daily, either as a single dose (in the morning) or in 2 divided doses of 5 mg (at breakfast and lunchtime). As oral lyophilisate tab: Initially, 1.25 mg daily. Hepatic Impairment Use caution; safety and efficacy not established

Child Dose

Safety and efficacy not established

Renal Dose

Renal Impairment Use caution; safety and efficacy not established

Administration

Should be taken with food.

Contra Indications

Active duodenal or gastric ulcer. Concomitant use w/ serotonin agonists (e.g. sumatriptan, zolmitriptan), pethidine and other opioids, antidepressants (including TCAs, MAOIs, SSRIs, serotonin norepinephrine reuptake inhibitors), St John's wort.

Precautions

Patient w/ uncontrolled HTN, angina, arrhythmias, psychosis, history of peptic ulcer and those at risk of orthostatic hypotension. Severe hepatic or renal impairment. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause somnolence, if affected, do not drive or operate machinery. Monitoring Parameters Monitor BP, symptoms of parkinsonism, suicidal ideation, general mood and behaviour. Perform periodic skin examinations. Lactation: unknown; use caution

Pregnancy-Lactation

Interactions

May increase risk of hypertensive reactions w/ dopamine. May increase bioavailability w/ OCs or drugs for hormone replacement therapy. Potentially Fatal: May cause severe serotonin syndrome w/ antidepressants (including TCAs, MAOIs, SSRIs, serotonin norepinephrine reuptake inhibitors), serotonin agonists (e.g. sumatriptan, zolmitriptan). May cause resp depression and hypotension w/ pethidine and other opioids.

Adverse Effects

Side effects of Selegiline : >10% Dyskinesia Nausea (20%) 1-10% Abdominal pain,Dry mouth Frequency Not Defined (selected) Arrhythmias,Confusion,EPS,Generalized pain,Hallucinations,Headache,HTN,Insomnia,Mood changes,Orthostatic hypotension,Syncope,Urinary retention,Vomiting

Mechanism of Action

Selegiline increases dopaminergic activity by intervening w/ the reuptake of dopamine at the synapse. It also irreversibly inhibits monoamine oxidase (MAO)-B which is involved in the metabolism of dopamine in the brain.