Selegiline Hydrochloride(se leh’ ge leen)
Apo-Selegiline (CAN), Eldepryl, Emsam, Gen-Selegiline (CAN), Zelapar
PREGNANCY CATEGORY C
Drug Classes
Antidepressant
Antiparkinsonian
MAO type B inhibitor
Therapeutic Actions
Mechanism of action not completely understood; inhibits MAO type B activity; may have other mechanisms of increasing dopaminergic activity.
Indications
Adjunct in management of patients with Parkinson disease whose response to levodopa and carbidopa has decreased
Treatment of major depressive disorder (Emsam)
Unlabeled use: Alzheimer disease
Contraindications and Cautions
Contraindicated with hypersensitivity to any component of the drug, pregnancy, lactation; concurrent use of carbamazepine or oxcarbazine, other MAOIs, methadone, tramadol, meperidine, dextromethorphan.
Use cautiously with geriatric patients.
Available Forms
Capsules—5 mg; tablets—5 mg; orally disintegrating tablets—1.25 mg; transdermal system—6 mg/24 hr, 9 mg/24 hr, 12 mg/24 hr
Dosages
Adults
Parkinson disease: 10 mg/day PO in divided doses of 5 mg each taken at breakfast and lunch. After 2–3 days, attempt to decrease dose of levodopa and carbidopa; reductions of 10%–30% are typical. If using orally disintegrating tablet, 1.25 mg/day PO in the morning before breakfast. Place tablet on top of tongue; avoid food or beverage for 5 min. May be increased after 6 wk to 2.5 mg/day. Patient should be under close supervision because of risk of altered mental state.
Depression: Apply one patch (Emsam) daily to dry, intact skin on upper torso, upper thigh, or outer surface of upper arm. Start with 6-mg/24-hr system and increase to maximum of 12 mg/24 hr if needed and tolerated.
Pediatric patients
Not recommended for children younger than 12 yr (transdermal) or 16 yr (orally disintegrating).
Geriatric patients
Usual dose of transdermal system, 6 mg/24 hr. Use with caution and carefully monitor for orthostatic BP changes.
Pharmacokinetics
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