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Precautions and Warnings With Orally Disintegrating Selegiline

Before using orally disintegrating selegiline, precautions and warnings associated with this medication should be reviewed. For instance, tell your healthcare provider about any other medications you are taking, as orally disintegrating selegiline can cause potentially dangerous (and even lethal) drug interactions. Precautions and warnings with orally disintegrating selegiline also apply to people who have certain allergies and to women who are pregnant or breastfeeding.

Orally Disintegrating Selegiline: What Should I Tell My Healthcare Provider?

Talk with your healthcare provider prior to taking orally disintegrating selegiline (Zelapar®) if you have:
 
  • Phenylketonuria
  • Liver disease, such as liver failure, hepatitis, or cirrhosis
  • Kidney disease, such as kidney failure (renal failure)
  • Any allergies, including allergies to foods, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Make sure to tell your healthcare provider about any other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Specific Precautions and Warnings With Orally Disintegrating Selegiline

Warnings and precautions to be aware of prior to taking orally disintegrating selegiline include the following:
 
  • Orally disintegrating selegiline has several potentially lethal drug interactions. In order to take the medication safely, you must commit to avoiding many medications, including several non-prescription medications. Always check with your healthcare provider before taking any medications (see Drug Interactions With Orally Disintegrating Selegiline).
     
  • The medication should not be taken at doses higher than 2.5 mg per day. Although no special diet is required for normal orally disintegrating selegiline doses (1.25 mg to 2.5 mg per day), higher doses of orally disintegrating selegiline interact dangerously with many foods.
     
  • Orally disintegrating selegiline can cause hypertensive crisis, which is a life-threatening increase in blood pressure. Tell your healthcare provider right away if you have symptoms of a hypertensive crisis, such as:
 
    • Headaches
    • Feelings of a rapidly or forcefully beating heart (palpitations)
    • A sore or stiff neck
    • Nausea or vomiting
    • Sweating, with a high fever (or sometimes with cold, clammy skin)
    • Sensitivity to light
    • A rapid heart rate (tachycardia) or low heart rate (bradycardia)
    • Chest pain or throat tightness
    • Dilated (wide open) pupils.
 
  • The liver and kidneys help remove orally disintegrating selegiline from the body. The medication has not been adequately studied in people with liver or kidney disease.
     
  • Taking orally disintegrating selegiline with levodopa medications (such as Sinemet®, Sinemet® CR, Parcopa®, or Stalevo®) can increase the risk of involuntary muscle movements, called dyskinesia. Although not typically dangerous, dyskinesia can be quite disturbing and intolerable. If you develop a severe dyskinesia while taking orally disintegrating selegiline and levodopa, your healthcare provider may need to decrease your levodopa dosage.
     
  • Orally disintegrating selegiline can cause low blood pressure (hypotension). Let your healthcare provider know if you develop signs of low blood pressure, such as dizziness, fainting, or lightheadedness.
     
  • The medication contains phenylalanine, an amino acid. This is important for people who have phenylketonuria, who must limit their intake of phenylalanine.
     
  • Orally disintegrating selegiline tablets can cause mouth irritation and sores.
     
  • Orally disintegrating selegiline can cause hallucinations (seeing, feeling, tasting, smelling, or hearing things that aren't there). Let your healthcare provider know if you think you may be hallucinating while taking the drug.

 

  • There have been a few reports of unusual compulsive behaviors, such as gambling, binge eating, or hypersexuality, in people taking orally disintegrating selegiline or other Parkinson's disease medications. Let your healthcare provider know if you develop any such behaviors while taking the drug. Also, let your friends, family, or caretakers know about this potential side effect, as they may be better able to identify the problem. 

 

  • Studies have suggested that people who take Parkinson's medications (including orally disintegrating selegiline) may have a higher risk of malignant melanoma (a type of skin cancer). However, it is not clear if this truly is a problem, as this may simply reflect the fact that people with Parkinson's have a higher risk of melanoma than normal.
     
  • Orally disintegrating selegiline is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Zelapar and Pregnancy).
     
  • It is not known if orally disintegrating selegiline passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Zelapar and Breastfeeding).
     
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