Selegiline Tablets

Generic name: Selegiline

Drug class: Monoamine oxidase B (MAO-B) inhibitor

Dosage form: Tablets

Route of administration: Oral

Dose:

• Parkinson’s disease: 5 mg once daily in the morning; may increase to 10 mg once daily after 2 weeks if needed.
• Major depressive disorder (adjunctive therapy): 5 mg once daily in the morning; may increase to 10 mg once daily after 2 weeks if needed.
• Off-label uses: Dosing varies; consult a healthcare provider for specific recommendations.

Mechanism of action: Selegiline selectively inhibits monoamine oxidase B (MAO-B), an enzyme responsible for the breakdown of dopamine in the brain, thereby increasing dopamine levels and improving motor function in Parkinson’s disease and enhancing mood in depression.

Drug usage cases:

• Parkinson’s disease
• Major depressive disorder (adjunctive therapy)
• Off-label: Alzheimer’s disease, cognitive enhancement, smoking cessation

Drug contraindications:

• Hypersensitivity to selegiline or any component of the formulation
• Concurrent use with non-selective monoamine oxidase inhibitors (MAOIs)
• Concurrent use with certain antidepressants (e.g., tricyclic antidepressants, SSRIs, SNRIs) due to risk of serotonin syndrome
• Concomitant use with sympathomimetic drugs (e.g., amphetamines, pseudoephedrine) due to risk of hypertensive crisis
• Concomitant use with meperidine or other opioid analgesics
• Concomitant use with tyramine-rich foods or beverages

Side effects:

• Common: Insomnia, dizziness, headache, nausea, dry mouth, abdominal pain, constipation, dyspepsia
• Serious: Hypertensive crisis, serotonin syndrome, hallucinations, orthostatic hypotension, dyskinesia, impulse control disorders

Warnings:

• Risk of hypertensive crisis with concurrent use of sympathomimetic drugs or consumption of tyramine-rich foods and beverages
• Risk of serotonin syndrome when used with other serotonergic agents
• May cause orthostatic hypotension; use caution when standing up quickly
• Potential for impulse control disorders; monitor for changes in behavior
• Use with caution in patients with a history of cardiovascular disease
• Discontinue at least 14 days before starting a non-selective MAOI

Use during pregnancy or breastfeeding:

Pregnancy: Category C. Animal studies have shown adverse effects on the fetus, but there are no adequate and well-controlled studies in humans. Selegiline should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Breastfeeding: It is not known whether selegiline is excreted in human milk. Due to the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.