Parkinson's disease
Adjunct
Selective MAO-B inhibitor as monotherapy in early Parkinson disease and as levodopa adjunct to reduce dose and motor fluctuations. SEN recognises a modest symptomatic effect.
Selective irreversible MAO-B inhibitor
ATC code: N04BD01 (Selegiline)
Brand names
Eldepryl, Zelapar, Emsam
Irreversibly blocks monoamine oxidase B and slows dopamine breakdown in the striatum. Used in Parkinson disease as early monotherapy or as add-on to levodopa. Up to 10 mg/day the MAO-B selectivity holds; above that, or when combined with SSRIs, SNRIs, tramadol or triptans, serotonin syndrome risk rises sharply.
Adjunct
Selective MAO-B inhibitor as monotherapy in early Parkinson disease and as levodopa adjunct to reduce dose and motor fluctuations. SEN recognises a modest symptomatic effect.
1 pair found. Sorted from critical to minor.
Mechanism
Selegiline at high doses loses MAO-B selectivity and inhibits MAO-A. Serotonin syndrome risk with triptans.
Symptoms
Agitation, tachycardia, hypertension.
Management
Avoid combination, especially with selegiline above 10 mg/day. Alternative – paracetamol for migraine attack.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Direct links to regulator labels. Open in a new tab.
FDA Category C. Pregnancy data are limited; animal studies do not show clear teratogenicity. For Parkinson disease SEN avoids MAO-B inhibitors in pregnancy, preferring levodopa and drugs with longer pregnancy experience.
Not compatible. Hale L4. No human milk transfer data. Given the stimulant amphetamine metabolites, AEMPS does not recommend breastfeeding during therapy.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Selegiline is evaluated for the following indications with varying evidence strength: Parkinson's disease (evidence tier B). See the full indication matrix with dosing and citations above on this page.
Common side effects of Selegiline (≥ 1 in 100): Insomnia, Dry mouth, Dizziness, Nausea, Orthostatic hypotension. See the Safety section for uncommon and serious reactions.
FDA category C. FDA Category C. Pregnancy data are limited; animal studies do not show clear teratogenicity. For Parkinson disease SEN avoids MAO-B inhibitors in pregnancy, preferring levodopa and drugs with longer pregnancy experience.
Not compatible. Hale L4. No human milk transfer data. Given the stimulant amphetamine metabolites, AEMPS does not recommend breastfeeding during therapy.
Selegiline is contraindicated in: Hypersensitivity to selegiline; Co-administration with other MAO inhibitors, SSRIs, SNRIs, TCAs, pethidine, tramadol, dextromethorphan; Phaeochromocytoma; Active peptic ulcer. Full list in the Safety section.