Drug Information Table

Indirect-acting Dopamine Receptor Agonists/MAO Inhibitors selegiline (Eldepryl, Zelapar ODT)

Therapeutic Use
Symptoms of Parkinsons
disease (PD) as an adjunct to
levodopa/carbidopa
Major depression transdermal
patch (Emsam)

Side/Adverse Effects

Administration
Give with levodopa/carbidopa
so that levodopa dosage may
be reduced
Give orallydisintegrating form
(Zelapar) by placing it on the
top of the tongue
Give before morning meal
Dont eat or drink for 5 min
before or after administration
Interventions

Patient Instructions

Insomnia

Monitor for this effect

Instruct patient to take last dose

of the day by noon to prevent
insomnia

Hypertension (as an interaction

with other drugs)

Carefully monitor other drugs

patient may be taking

Instruct patient to notify

provider before taking any new
drugs
Instruct patient about foods to
avoid
Inform patient of drugs,
including herbals, which may
interact with selegiline

Orthostatic hypotension

Monitor BP while taking this

drug
Monitor orthostatic BP and
pulse

Advise patient to rise slowly

from lying or sitting position

Irritation of oral mucous

membranes (with orallydisintegrating form)

Inspect tongue and oral cavity

for irritation
Refer to dentist if necessary

Instruct patient to report

irritation to provider

Hallucinations

Monitor for this effect

Educate patient about risk of

hallucinations and to report to
provider if this occurs

Contraindications
Uncontrolled hypertension
Suicidal ideations
Receiving meperidine for pain
Concurrent use with
dextromethorphan, other
MAOIs (e.g., phenelzine),
meperidine, methadone, or
tramadol

Precautions
Hypertension
Bipolar disorder or psychosis
Lactation

Interactions
Meperidine (Demerol) and other
opioids, other MAOIs, tricyclic
or SSRI antidepressants can
cause high fever, hypertension,
rigidity
Foods containing tyramine
can cause hypertension (less
likely to do so than other MAOI
drugs)
Herbal drugs, such as ephedra,
St. Johns wort, ginseng, or
ma huang can cause severe
hypertension
Antihypertensive drugs,
diuretics or general anesthetics
can cause hypotension