Eldepryl

Selegiline




(se le' ji leen)

Eldepryl®
Zelapar®

Transdermal selegiline is used to treat depression. Selegiline is in a class of medications called monoamine oxidase (MAO) inhibitors. It works by increasing the amounts of certain natural substances that are needed to maintain mental balance.

Transdermal selegiline comes as a patch to apply to the skin. It is usually applied once a day and left in place for 24 hours. Remove your old selegiline patch and apply a new patch at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use transdermal selegiline exactly as directed. Do not apply more patches or apply patches more often than prescribed by your doctor.
Your doctor may start you on a low dose of transdermal selegiline and gradually increase your dose, not more often than once every 2 weeks.
Transdermal selegiline controls depression but does not cure it. Your condition may begin to improve after you have used transdermal selegiline for one week or longer. However, you should continue to use transdermal selegiline even if you feel well.  Do not stop using transdermal selegiline without talking to your doctor.
Apply selegiline patches to dry, smooth skin anywhere on your upper chest, your back (between your neck and your waist), your upper thigh, or the outer surface of your upper arm. Choose an area where the patch will not be rubbed by tight clothing. Do not apply selegiline patches to skin that is hairy, oily, irritated, broken, scarred, or calloused.
After you apply a selegiline patch, you should wear it all the time until you are ready to remove it and put on a fresh patch. If the patch loosens or falls off before it is time to replace it, try to press it back in place with your fingers. If the patch cannot be pressed back on, dispose of it and apply a fresh patch to a different area. Replace the fresh patch at your regularly scheduled patch change time.
Do not cut selegiline patches.
While you are wearing a selegiline patch, protect the patch from direct heat such as heating pads, electric blankets, heat lamps, saunas, hot tubs, and heated water beds. Do not expose the patch to direct sunlight for very long.
To use the patches, follow these steps:



Choose the area where you will apply the patch. Wash the area with soap and warm water. Rinse off all of the soap and dry the area with a clean towel.

Open the protective pouch and remove the patch.

Peel the first piece of liner off the sticky side of the patch. A second strip of liner should remain stuck to the patch.

Press the patch firmly onto your skin with the sticky side down. Be careful not to touch the sticky side with your fingers.

Remove the second strip of protective liner and press the rest of the sticky side of the patch firmly against your skin. Be sure that the patch is pressed flat against the skin with no bumps or folds and that it is firmly attached.

Wash your hands with soap and water to remove any medicine that may have gotten on them. Do not touch your eyes until you have washed your hands.

After 24 hours, peel the patch off slowly and gently. Fold the patch in half with the sticky sides together and dispose of it safely, so that is out of reach of children and pets. Children and pets can be harmed if they chew on, play with, or wear used patches.

Wash the area that was under the patch with mild soap and warm water to remove any residue. If necessary, you can use baby oil or a medical adhesive removal pad to remove residue that will not come off with soap and water. Do not use alcohol, nail polish remover, or other solvents.

Apply a new patch to a different area immediately by following steps 1 to 6.

Before taking selegiline,

tell your doctor and pharmacist if you are allergic to selegiline, or any other medications.

tell your doctor if you are taking, have recently taken, or plan to take any of the following prescription and nonprescription medications: dextromethorphan (Robitussin); meperidine (Demerol); methadone (Dolophine), propoxyphene (Darvon); tramadol (Ultram, in Ultracet); and other medications that contain selegiline (Eldepryl, Emsam, Zelapar). Your doctor may tell you not to take selegiline if you are taking or have recently taken any of these medications. If you stop taking selegiline, your doctor may tell you not to take these medications until at least 14 days have passed since you last took selegiline.

tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: antidepressants such as amitriptyline (Elavil) and imipramine (Tofranil); carbamazepine (Carbatrol, Equetro); medications for cough and cold symptoms or for weight loss;  nafcillin; phenobarbital; phenytoin (Dilantin); selective serotonin reuptake inhibitors such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); and rifampin (Rifadin, Rimactane). Your doctor may need to change the doses of your medications or monitor you more carefully for side effects.

tell your doctor if you have or have ever had liver or kidney disease.

if you have phenylketonuria (PKU; an inherited condition in which a special diet must be followed to prevent mental retardation), you should know that the orally disintegrating tablets contain phenylalanine.

tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking selegiline, call your doctor.

you should know that selegiline may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking selegiline. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

Ask your doctor if you need to avoid any foods during your treatment with selegiline. Your doctor will probably tell you that you may continue your normal diet as long as you take selegiline exactly as directed.

Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Selegiline may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:



dizziness

lightheadedness

fainting

dry mouth

nausea

vomiting

stomach pain

difficulty swallowing

heartburn

diarrhea

gas

constipation

difficulty falling asleep or staying asleep

unusual dreams

sleepiness 

depression

pain, especially in the legs or back

muscle pain or weakness

purple blotches on the skin

rash

redness, irritation, or sores in the mouth (if you are taking the orally disintegrating tablets) 

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:



severe headache

chest pain

fast, irregular, or pounding heartbeat

sweating

sudden, severe nausea and vomiting

confusion

stiff or sore neck

uncontrollable shaking of a part of your body

unusual movements that are difficult to control

hallucinations (seeing thing or hearing voices that do not exist)

difficulty breathing
People who have PD may have an increased risk of developing melanoma (a type of skin cancer). There is not enough information to tell whether selegiline or other medications for PD increase the risk of melanoma. Talk to your doctor about the risks of taking selegiline and about whether you should have your skin examined during your treatment.
Selegiline may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Dispose of any unused orally disintegrating tablets three months after you open the protective pouch.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them.  However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community.  See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.