Common use
Eldepryl (selegiline) is a selective monoamine oxidase type B (MAO‑B) inhibitor used in Parkinson’s disease (PD). By inhibiting MAO‑B in the brain, it slows dopamine breakdown, helping stabilize motor control. Clinically, Eldepryl is prescribed to reduce “off” episodes in patients on levodopa/carbidopa, improve rigidity and bradykinesia, and smooth motor fluctuations. Many patients experience longer “on” periods and may require lower levodopa doses over time.
In early PD, some clinicians use selegiline as initial therapy to potentially delay the need for higher doses of dopaminergic drugs. Unlike the transdermal selegiline system used for depression, oral Eldepryl is indicated for PD and is not an antidepressant. Its benefits are most evident as adjunct therapy alongside levodopa, particularly when “wearing‑off” has emerged.
Dosage and direction
The typical starting dose of Eldepryl for Parkinson’s disease is 5 mg taken by mouth twice daily, usually at breakfast and lunch. Morning and midday dosing helps minimize insomnia, a common stimulant‑like effect related to metabolites of selegiline. Swallow capsules or tablets with water; do not take late in the day unless directed by your prescriber. Eldepryl is not a rescue medication and must be taken consistently to maintain benefit.
When Eldepryl is added to levodopa/carbidopa, your clinician may adjust the levodopa dose after monitoring your response, as selegiline can enhance dopaminergic effects. Do not increase or decrease Eldepryl on your own. If you are switching from, or to, other MAO inhibitors or serotonergic antidepressants, specific washout periods are required to lower the risk of serotonin syndrome; your prescriber will set safe timelines.
Never stop Eldepryl abruptly without medical advice. If your regimen changes (for example, surgery or new medicines), inform your care team so they can manage potential interactions and plan a taper if needed. Always follow the exact instructions on your prescription label.
Precautions
Tell your healthcare professional about all medical conditions and medicines before starting Eldepryl. Report any history of high blood pressure, orthostatic hypotension, heart rhythm problems, psychiatric symptoms (hallucinations, depression, bipolar disorder), liver disease, kidney disease, or peptic ulcer. Older adults may be more sensitive to dizziness, confusion, or low blood pressure upon standing.
At the recommended PD doses, selegiline is selective for MAO‑B, and a tyramine‑restricted diet is generally not required. However, at higher doses or with interacting drugs, dietary tyramine can precipitate hypertensive reactions. Use caution with aged cheeses, cured meats, and certain fermented products if your clinician advises a restriction.
Selegiline may cause insomnia; avoid dosing later in the day. It can also intensify dyskinesias in patients on levodopa; dose adjustments may help. Rarely, impulse‑control symptoms (pathologic gambling, hypersexuality) or hallucinations can occur; notify your clinician immediately if behavior changes arise. Use caution when driving or operating machinery until you know how Eldepryl affects you.
Contraindications
Eldepryl is contraindicated in patients with known hypersensitivity to selegiline or formulation components. Do not use Eldepryl with meperidine, tramadol, methadone, propoxyphene, or dextromethorphan due to the risk of serious reactions including serotonin syndrome. Concomitant use with other MAO inhibitors (including linezolid or intravenous methylene blue) is also contraindicated.
Avoid combining Eldepryl with serotonergic antidepressants (SSRIs, SNRIs, TCAs), buspirone, or St. John’s wort unless a clinician carefully coordinates transitions with adequate washout periods. As general guidance, allow at least 14 days between discontinuing Eldepryl and starting most serotonergic agents, and at least 14 days after stopping most serotonergic agents before starting Eldepryl; a longer washout (e.g., 5 weeks) is recommended after fluoxetine because of its long half‑life. Always follow prescriber‑specific timelines.
Possible side effects
Common side effects include insomnia, nausea, dry mouth, dizziness, lightheadedness on standing, and headache. When combined with levodopa, patients may notice increased dyskinesias or nausea; careful adjustment of levodopa can mitigate these effects. Some people experience agitation or anxiety, which can improve by moving doses earlier in the day or with dose changes under supervision.
Less common but important adverse effects include hallucinations, confusion, orthostatic hypotension with fainting, impulse‑control problems, and arrhythmias. Serotonin syndrome can occur if combined with serotonergic agents, presenting with agitation, sweating, shivering, muscle rigidity, fast heart rate, and high fever—seek emergency care. Hypertensive reactions are rare at PD doses but may arise with significant tyramine exposure or interacting drugs; severe headache, chest pain, or vision changes warrant urgent evaluation.
Report rash, severe gastrointestinal upset, or any sudden change in behavior or mood to your clinician. As with all PD therapies, monitor skin for new or changing lesions and discuss melanoma screening, since Parkinson’s disease itself is associated with an increased melanoma risk.
Drug interactions
Selegiline’s MAO‑B inhibition creates important interaction risks. Combining Eldepryl with SSRIs, SNRIs, TCAs, MAO inhibitors, linezolid, IV methylene blue, or St. John’s wort increases the risk of serotonin syndrome and should be avoided unless transitions are carefully managed with washouts. Do not use with meperidine, tramadol, methadone, propoxyphene, or dextromethorphan.
Sympathomimetic agents found in certain decongestants (e.g., pseudoephedrine), stimulants, or weight‑loss products can dangerously elevate blood pressure with MAO inhibition; avoid unless a prescriber determines the combination is safe. Eldepryl may also interact with some anesthetics; inform your surgical team well before any procedure. Alcohol can worsen dizziness and impair coordination—use caution.
When Eldepryl is added to levodopa, dopaminergic side effects may intensify; clinicians often lower levodopa dosage. Certain antipsychotics can reduce dopaminergic benefit and may exacerbate motor symptoms. Always provide a complete, up‑to‑date medication and supplement list (including over‑the‑counter cold remedies and herbal products) to every clinician and pharmacist caring for you.
Missed dose
If you miss a dose of Eldepryl, take it when you remember unless it is late in the day or close to your next scheduled dose. Because selegiline can cause insomnia, it is generally better to skip a late dose rather than take it in the evening. Do not double up to make up for a missed dose. Resume your regular schedule the following day and consult your clinician if missed doses become frequent.
Overdose
Overdose symptoms may include severe headache, chest pain, rapid or irregular heartbeat, marked hypertension or hypotension, agitation, confusion, hallucinations, severe nausea or vomiting, muscle rigidity, high fever, and in extreme cases coma. This can be life‑threatening, especially if other interacting substances are involved. There is no specific antidote; management is supportive in a monitored medical setting.
If an overdose is suspected, call emergency services or your local poison control center immediately. Do not wait for symptoms to worsen. Bring medication containers to the hospital if possible to assist with identification and treatment decisions.
Storage
Store Eldepryl at room temperature, away from excessive heat, moisture, and direct light. Keep tablets or capsules in a tightly closed, child‑resistant container, and do not store in the bathroom. Dispose of expired or unused medication according to pharmacist or community take‑back guidance; do not flush unless specifically instructed. Keep out of reach of children and pets.
U.S. Sale and Prescription Policy
In the United States, Eldepryl is a prescription‑only medication. While people search online for ways to buy Eldepryl without prescription, it is neither legal nor safe to obtain prescription drugs without a valid prescription from a licensed clinician. Purchasing from unverified sources increases risks of counterfeit products, contamination, incorrect dosing, and harmful interactions.
HealthSouth Rehabilitation Hospital of Tallahassee, like reputable U.S. healthcare institutions, follows federal and state regulations. They can provide structured clinical evaluation, diagnose and manage Parkinson’s disease, and—when appropriate—issue a legitimate prescription that is filled through licensed pharmacies or coordinated specialty pharmacy services. Many patients also access care via telemedicine visits, which can streamline evaluation and prescription management without compromising safety.
For legal access and affordability, consult a neurologist or movement‑disorder specialist, ask about generic selegiline, and explore insurance formularies or manufacturer assistance programs. Verify pharmacies through state boards or NABP tools, and be cautious of websites that offer prescription drugs without requiring a valid prescription. Your care team can help you obtain Eldepryl safely, legally, and cost‑effectively.
