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Zelapar
Zelapar (generic name: selegiline) is a medication used to manage symptoms of Parkinson’s disease. It is an MAO-B inhibitor that works by increasing levels of dopamine in the brain, which helps improve motor function and reduce symptoms such as tremors, stiffness, and slow movement. Zelapar is typically used as an adjunct therapy to levodopa/carbidopa in patients experiencing "off" episodes (periods when symptoms return as the effect of levodopa wears off).
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Frequently Asked Questions
How long does it take for Zelapar to work?
Zelapar typically begins working within a few hours of administration, with full effects on symptom control seen within several days to weeks.
Can I stop taking Zelapar suddenly?
No, stopping Zelapar suddenly can lead to withdrawal symptoms and worsening of Parkinson’s symptoms. Always consult your healthcare provider before discontinuing the medication.
Can Zelapar be used alone to treat Parkinson’s disease?
Zelapar is typically used as an adjunct therapy to levodopa/carbidopa. It is not usually used alone for the treatment of Parkinson’s disease.
Can I take Zelapar with antidepressants?
Zelapar should not be taken with SSRIs, SNRIs, or tricyclic antidepressants due to the risk of serotonin syndrome. Consult your healthcare provider for alternative treatment options.
What should I do if I miss a dose of Zelapar?
If you miss a dose of Zelapar, take it as soon as you remember. If it’s close to your next dose, skip the missed dose and take your next scheduled dose. Do not double the dose to make up for the missed one.
Comprehensive Drug Guide
How Does Zelapar Work?
Zelapar works by selectively inhibiting monoamine oxidase-B (MAO-B), an enzyme that breaks down dopamine in the brain. By preventing the breakdown of dopamine, Zelapar increases dopamine levels, helping to improve motor control and reduce symptoms of Parkinson’s disease.
Common Dosages
- 1.25 mg orally disintegrating tablet
Typical Dosing
- The typical starting dose of Zelapar is 1.25 mg once daily, taken in the morning. The tablet should be allowed to dissolve on the tongue without chewing or swallowing it whole.
- The dose can be adjusted based on patient response, but the maximum recommended dose is 2.5 mg per day.
Typical Dosing
FDA Approved Indications
- Adjunct treatment of Parkinson’s disease in patients receiving levodopa/carbidopa who are experiencing "off" episodes.
Who Shouldn't Take Zelapar?
- Hypersensitivity to selegiline or any of the ingredients in the formulation.
- Concomitant use of certain medications, including opioids (e.g., meperidine), tricyclic antidepressants, or SSRIs, due to the risk of serotonin syndrome.
- Pheochromocytoma (a type of tumor that can cause high blood pressure).
Advice From The Pharmacist
- Take Zelapar in the morning before eating or drinking to avoid food interaction, as this may affect its absorption.
- Allow the tablet to dissolve on the tongue completely without chewing, swallowing, or using water.
- Avoid consuming foods high in tyramine (e.g., aged cheese, cured meats) while taking Zelapar, as this may increase the risk of high blood pressure (hypertensive crisis).
- Monitor blood pressure regularly, especially during the initial stages of treatment or when adjusting the dose.
Side Effects of Zelapar
Common Side Effects
- Nausea
- Dizziness
- Dry mouth
- Insomnia
- Headache
Uncommon/Severe Side Effects
- Hypertensive crisis (increased blood pressure, headache, blurred vision)
- Serotonin syndrome (confusion, rapid heart rate, fever)
- Hallucinations or psychosis, especially in patients with advanced Parkinson’s disease
Risks and Warnings of Zelapar
- Hypertensive Crisis: Zelapar can interact with foods containing tyramine, leading to dangerously high blood pressure. Patients should avoid tyramine-rich foods while taking the medication.
- Serotonin Syndrome: Concomitant use of Zelapar with SSRIs, SNRIs, TCAs, or other serotonergic medications can increase the risk of serotonin syndrome, which can be life-threatening. Symptoms include confusion, rapid heart rate, and muscle rigidity.
- Impulse Control Disorders: Some patients taking Zelapar in combination with other Parkinson’s medications have reported impulse control disorders (e.g., gambling, hypersexuality).
Interactions with Zelapar
Common Drug Interactions
- Tyramine-rich foods: Consuming large amounts of aged cheese, cured meats, or fermented foods may lead to a hypertensive crisis. Avoid such foods while on Zelapar.
- Opioids: Using meperidine, tramadol, or methadone with Zelapar can increase the risk of serotonin syndrome.
- Antidepressants: Avoid using SSRIs, SNRIs, or tricyclic antidepressants with Zelapar due to the risk of serotonin syndrome.
Alternatives to Zelapar
- Rasagiline (Azilect): Another MAO-B inhibitor used in the treatment of Parkinson’s disease.
- Amantadine: An antiviral medication also used for Parkinson’s symptoms.
- Entacapone (Comtan): A COMT inhibitor used with levodopa to extend its effects.
- Pramipexole (Mirapex): A dopamine agonist used to manage Parkinson’s disease symptoms.
