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Zelapar (Generic Selegiline)

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Why is this medication prescribed?

Zelapar is a brand name for the medication selegiline, which belongs to a class of drugs known as monoamine oxidase inhibitors (MAOIs). It is primarily prescribed for the treatment of Parkinson’s disease. Parkinson’s disease is a neurodegenerative disorder that affects movement control. Zelapar is often used as an adjunct to levodopa/carbidopa therapy in patients with Parkinson’s disease who experience fluctuations in their symptoms.

Selegiline works by inhibiting the activity of monoamine oxidase type B (MAO-B), an enzyme that breaks down dopamine in the brain. Dopamine is a neurotransmitter that plays a crucial role in coordinating smooth and controlled movements.

How should this medicine be used?

Here are general guidelines for using Zelapar:

  • Dosage: The usual recommended starting dose of Zelapar is 1.25 mg once daily. The dosage may be increased gradually as needed, but it should not exceed 2.5 mg per day.
  • Administration: Zelapar is typically taken orally and is designed to dissolve on the tongue. It is usually taken in the morning before breakfast, without water. It’s important to avoid swallowing the tablet whole or chewing it, as it is designed to be absorbed through the mucous membranes in the mouth.
  • Food Interactions: Certain foods, especially those high in tyramine, can interact with MAOIs and cause a potentially dangerous increase in blood pressure. Therefore, individuals taking Zelapar should follow a low-tyramine diet. Foods to be avoided include aged cheeses, certain meats, and fermented products.
  • Other Medication Interactions: Zelapar can interact with other medications, including antidepressants and other MAOIs, leading to a potentially serious condition called serotonin syndrome. Therefore, it’s crucial to inform your healthcare provider about all medications, including over-the-counter drugs and herbal supplements, that you are taking.
  • Monitoring: Regular medical check-ups are important to monitor the response to the medication and check for any potential side effects or interactions.

It’s important to note that specific dosages and recommendations may vary based on individual patient characteristics, and these guidelines are a general overview. Always follow the instructions provided by your healthcare provider and consult with them regarding any questions or concerns about your medication. Never adjust your dosage or stop taking the medication without consulting your healthcare provider, as doing so may have adverse effects on your health.

Other uses for this medicine

Zelapar (selegiline) is primarily prescribed for Parkinson’s disease, as mentioned earlier. However, in some cases, it may be used off-label for other purposes. Off-label use means that the medication is being used for a purpose not approved by regulatory authorities. The decision to use Zelapar for conditions other than Parkinson’s disease should be made by a healthcare professional based on their assessment of the individual’s needs and the potential risks and benefits.

What special precautions should I follow?

Here are some special precautions to keep in mind when using Zelapar:

  • Monoamine Oxidase Inhibitor (MAOI) Interactions: Zelapar is an MAOI, and it can interact with other medications, particularly those that affect serotonin levels. This includes certain antidepressants and other MAOIs. Combining these medications can lead to a potentially life-threatening condition known as serotonin syndrome. Inform your healthcare provider about all medications, including prescription and over-the-counter drugs, as well as herbal supplements, that you are taking.
  • Tyramine-Restricted Diet: Like other MAOIs, Zelapar requires adherence to a low-tyramine diet to avoid hypertensive crises. Foods rich in tyramine, such as certain aged cheeses, fermented or pickled products, and certain meats, should be limited or avoided.
  • Hypertensive Crises: There is a risk of hypertensive crises (dangerously high blood pressure) when MAOIs like Zelapar are combined with certain medications or foods. This can lead to serious health complications. It is crucial to follow dietary restrictions and inform healthcare providers about all medications being taken.
  • Hepatic Impairment: Zelapar should be used with caution in individuals with hepatic (liver) impairment. Your healthcare provider will consider the overall health of your liver when prescribing this medication.
  • Cardiovascular Disease: Caution is advised in individuals with cardiovascular disease, as MAOIs may have cardiovascular effects.
  • Seizure Disorders: Selegiline should be used cautiously in individuals with a history of seizures.
  • Pregnancy and Breastfeeding: The safety of Zelapar during pregnancy and breastfeeding has not been well established. It is important to discuss the potential risks and benefits with your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding.

Always follow your healthcare provider’s instructions and inform them about any pre-existing medical conditions, medications, or supplements you are taking. Never make changes to your medication regimen without consulting your healthcare provider, as abrupt changes can have serious consequences. If you experience any concerning side effects or have questions about your medication, seek prompt medical advice.

What special dietary instructions should I follow?

As mentioned earlier, follow a low-tyramine diet to avoid hypertensive crises. Consult with a healthcare professional or a dietitian for specific dietary guidelines.

What should I do if I forget a dose?

If you forget to take a dose of Zelapar, follow these general guidelines:

  • Missed Dose: If you forget to take a dose, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue with your regular schedule.
  • Double Dosing: Do not double the dose to make up for a missed one, as this can increase the risk of side effects.

What side effects can this medication cause?

Zelapar (selegiline) can cause various side effects. It’s important to note that not everyone will experience these side effects, and their severity can vary. Additionally, the combination of Zelapar with certain medications or foods can increase the risk of side effects. Always inform your healthcare provider of all medications and supplements you are taking to avoid potential interactions. Here are some potential side effects associated with Zelapar:

Common Side Effects:

  • Dizziness or Lightheadedness: Changes in body position, such as standing up quickly, may cause dizziness or lightheadedness.
  • Insomnia (Difficulty Sleeping): Zelapar is sometimes associated with difficulty sleeping, especially if taken later in the day.

Less Common or Serious Side Effects:

  • Hypertensive Crisis: Interaction with certain foods or medications can cause a sudden and severe increase in blood pressure, leading to a hypertensive crisis. Foods high in tyramine, certain medications, and other MAOIs should be avoided.
  • Serotonin Syndrome: Combining Zelapar with certain medications, especially those that affect serotonin levels, can lead to serotonin syndrome. Symptoms include confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. This is a serious condition that requires immediate medical attention.
  • Hallucinations or Confusion: Some individuals may experience hallucinations or confusion.
  • Nausea and Upset Stomach: Gastrointestinal symptoms such as nausea or upset stomach may occur.
  • Dry Mouth: Some people may experience dry mouth as a side effect.
  • Orthostatic Hypotension: A sudden drop in blood pressure upon standing, leading to dizziness or fainting.
  • Edema (Swelling): Swelling, especially in the legs and ankles, may occur.
  • Skin Reactions: Rarely, skin reactions such as rash may occur.
  • Monoamine Oxidase Inhibitor Withdrawal Syndrome: If MAOIs are discontinued abruptly, withdrawal symptoms may occur, including mood changes, dizziness, and flu-like symptoms.

Keep in mind that this is not an exhaustive list of side effects, and individual reactions may vary. If you experience any concerning symptoms while taking Zelapar, seek medical attention promptly. Always discuss any potential side effects or concerns with your healthcare provider.

What should I know about storage and disposal of this medication?

Storage and Disposal of Zelapar:

  • Storage:
    • Store Zelapar at room temperature, away from moisture and heat.
    • Keep it in its original packaging to protect it from light.
    • Avoid storing it in the bathroom.
  • Disposal:
    • Dispose of unused or expired Zelapar in accordance with local regulations.
    • Do not flush medications down the toilet or pour them into a drain unless instructed to do so.
    • Consult your healthcare provider or pharmacist on the proper disposal method.

In case of emergency/overdose

  • In case of an overdose or emergency, contact your local poison control center or emergency room immediately.
  • Symptoms of overdose may include severe headache, hallucinations, irregular heart rate, and other serious side effects.
  • If possible, bring the medication container or packaging to the emergency room to aid in the treatment.

What other information should I know?

  • Regular Monitoring: Attend regular check-ups with your healthcare provider to monitor your response to Zelapar and assess for any side effects.
  • Inform Healthcare Providers: Inform all healthcare providers (doctors, dentists, surgeons, etc.) about your use of Zelapar before undergoing any medical procedures or surgeries.
  • Avoid Alcohol: Limit or avoid alcohol consumption while taking Zelapar, as it can increase the risk of side effects.
  • Interaction with Other Medications: Be aware of potential interactions with other medications, including over-the-counter drugs and herbal supplements. Inform your healthcare provider about all medications you are taking.
  • Medical Alert Bracelet: Consider wearing a medical alert bracelet or carrying a card indicating that you are taking an MAOI in case of emergency.
  • Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the potential risks and benefits with your healthcare provider.
  • Dietary Guidelines: Adhere to dietary guidelines, especially avoiding foods high in tyramine, to prevent hypertensive crises.
  • Symptoms of Hypertensive Crisis: Be aware of symptoms of hypertensive crises (severe headache, rapid heartbeat, chest pain, etc.) and seek immediate medical attention if they occur.
  • Informing Caregivers: If you are unable to communicate during an emergency, inform caregivers or family members about your use of Zelapar and provide them with relevant information.

Always follow the instructions provided by your healthcare provider and the medication’s packaging. If you have any questions or concerns, don’t hesitate to contact your healthcare provider or pharmacist for clarification and guidance.

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