Eldepryl (selegiline) is used to help control the symptoms of Parkinson’s disease (PD) by increasing the amount of dopamine in the brain. Dopamine is a naturally occurring substance that is needed to control movement and its levels are reduced in people with PD. It is intended as an add-on therapy for PD patients who are taking levodopa and carbidopa.
How Eldepryl works
Eldepryl is a selective monoamine oxidase B (MAO-B) inhibitor. MAO-B is an enzyme that breaks down dopamine in the brain. By inhibiting the action of MAO-B enzyme, Eldepryl, leads to an increase in the amount of dopamine. As a result, the dose of levodopa/carbidopa needed to control PD symptoms can be decreased, helping to stop the effect of those therapies wearing off between doses.
Randomized controlled studies that compared the effects of added Eldepryl or placebo in participants receiving levodopa/carbidopa showed that Eldepryl was significantly superior to placebo on all three principal objectives measures assessed: Change from baseline in daily levodopa/carbidopa dose; the amount of ‘off-time‘; and participants’ self-assessment of treatment success. Beneficial effects also were observed on other symptom-improvement measures.
Although there is no evidence from controlled studies that Eldepryl has a beneficial effect in the absence of concurrent levodopa therapy, double-blind studies in people recently diagnosed with PD showed that participants receiving Eldepryl monotherapy managed significantly longer without levodopa therapy than those receiving placebo. These participants also maintained the ability to work longer.
It is to be taken orally twice a day, usually at breakfast and with lunch. It may be started on a low dose and increased after six weeks to the ideal dose.
Eldepryl should not be taken together with antidepressants containing fluoxetine.
After discontinuing Eldepryl, five weeks should elapse before treatment is restarted.
Foods that are high in tyramine, an amino acid that helps regulate blood pressure, and may cause high-blood pressure that can be life-threatening. Therefore, these foods must not be eaten while taking Eldepryl and for 14 days after stopping the treatment:
- Air dried meats, aged or fermented meats, sausage or salami, pickled herring
- Any spoiled or improperly stored beef, poultry, fish or liver
- Beer from a tap or that has not been pasteurized
- Aged cheeses
- Supplements or medicines that contain tyramine, such as some cough and cold medicines
- Sauerkraut, soy beans, soy sauce, tofu, fava beans
- Yeast extracts.
Eldepryl also should not be used along with other selegiline products such as Zelapar, as this may lead to a severe increase in blood pressure.
Common side effects include dizziness, nausea, stomach pain, constipation, skin rash or irritation, and sleep problems.
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