Selegiline

1 medicine

Selegiline is a selective MAO-B inhibitor used in Parkinson's disease and depression. At higher doses it loses its selectivity and can cause a dangerous rise in blood pressure with tyramine-rich foods or serotonin syndrome with certain other medicines.

Eldepryl

Selegiline

5/10mg

Eldepryl is a neurology medication containing Selegiline, available as 5/10mg tablets.

from $0.63 / tablet View

Key facts

  • Selegiline (sold as Eldepryl, among other brands) blocks monoamine oxidase-B (MAO-B), an enzyme that breaks down dopamine, helping dopamine last longer in the brain.
  • At the low doses used for Parkinson's disease, selegiline is selective for MAO-B. At higher doses, including some antidepressant formulations, it also blocks MAO-A and behaves like an older-style MAOI antidepressant.
  • Combining selegiline with other serotonin-raising medicines, or eating large amounts of tyramine-rich food, such as aged cheese, cured meats or tap beer, at higher doses can trigger serotonin syndrome or a dangerous spike in blood pressure.
  • Seek urgent care for a severe headache with visual changes, a racing heart, high fever, agitation or muscle rigidity.

What selegiline treats

Selegiline is used in Parkinson's disease, often alongside levodopa, to help smooth out the "wearing-off" periods when levodopa's effect fades before the next dose. A higher-dose oral tablet, and a transdermal patch at higher strengths, are used to treat major depression.

How selegiline works

Dopamine, the brain chemical that helps control smooth movement, is normally broken down by the enzyme MAO-B. Selegiline blocks this enzyme, so more dopamine remains active in the brain, which can ease Parkinson's symptoms and support steadier mood. At doses high enough to also block MAO-A, it slows the breakdown of serotonin and noradrenaline as well, which is how the higher-dose antidepressant forms work, but this also brings the food and drug interaction risks of a full MAOI.

Before you take it

  • Never combine selegiline with an SSRI, SNRI, tricyclic antidepressant, the painkiller pethidine (meperidine), tramadol, or St John's wort. Together these can cause serotonin syndrome, which can be life-threatening.
  • If you are prescribed a higher-dose or antidepressant form, ask your pharmacist whether you need to limit tyramine-rich foods and drinks, since this interaction is dose-dependent.
  • Tell your prescriber about any other Parkinson's or psychiatric medicines you take, and about planned surgery, since selegiline can interact with some anesthetics.

Side effects

Common effects include nausea, dizziness, dry mouth, and trouble sleeping.

Stop and seek urgent medical care for any of these:

  • A sudden, severe headache with visual changes or a pounding heartbeat, which can signal a hypertensive crisis.
  • High fever, confusion, muscle rigidity or twitching, and a racing heartbeat, which can signal serotonin syndrome.
  • Fainting or a significant drop in blood pressure on standing.

Safety essentials

  • Selegiline's selectivity for MAO-B is dose-dependent. Never exceed your prescribed dose, since higher doses bring MAOI-level risks of hypertensive crisis and serotonin syndrome.
  • Never combine it with another antidepressant, tramadol or pethidine. Leave the washout period your prescriber specifies when switching between selegiline and these drugs.
  • Ask your pharmacist whether your specific dose and formulation requires tyramine food restrictions.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.