Selegiline Dissolving Tablets

What is this medication?

SELEGILINE (se LE ji leen) treats the symptoms of Parkinson disease in people who are taking the medication Levodopa. It works by increasing the amount of dopamine in your brain, a substance which helps manage body movements and coordination. This reduces the symptoms of Parkinson, such as body stiffness and tremors. It belongs to a group of medications called MAOIs.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Zelapar

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• High blood pressure
• Liver disease
• Low blood pressure
• Narcolepsy
• Phenylketonuria
• Sleep apnea
• An unusual or allergic reaction to selegiline, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth in the morning. Follow the directions on the prescription label. Do not push the tablet through the foil backing. Peel back the foil with dry hands, gently remove the tablet, and immediately place the tablet on your tongue. It will dissolve in seconds. Do not swallow it. Wait about 5 minutes after taking your medication before ingesting any food or liquid. Take your doses at regular intervals. Do not take your medication more often than directed. Do not stop taking except on the advice of your care team.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

Do not take this medication with any of the following:

• Atomoxetine
• Cyclobenzaprine
• Dextromethorphan
• MAOIs like Marplan, Nardil, and Parnate
• Meperidine
• Methadone
• Other medications containing selegiline, like Emsam or Eldepryl
• Rasagiline
• Safinamide
• Stimulant medications for attention disorders
• St. John's Wort
• Tramadol
• Viloxazine

This medication may also interact with the following:

• Certain medications for depression, anxiety, or psychotic disorders
• Certain medications for seizures like carbamazepine, phenobarbital, phenytoin
• Ephedrine
• Epinephrine or racepinephrine
• Medications for nasal congestion like phenylephrine, pseudoephedrine
• Metoclopramide
• Nafcillin
• Narcotic medications for pain
• Norepinephrine
• Rifampin
• Stimulant medications for weight loss or staying awake

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse. Do not stop taking except on your care team's advice. You may develop a severe reaction. Your care team will tell you how much medication to take.

This medication can interact with certain foods that contain high amounts of tyramine. The combination may cause severe headaches, a rise in blood pressure, or irregular heartbeat. Foods that contain significant amounts of tyramine include aged cheeses, meats and fish (especially aged, smoked, pickled, or processed such as bologna, pepperoni, salami, summer sausage), beer and ale, alcohol-free beer, wine (especially red), sherry, hard liquor, liqueurs, avocados, bananas, figs, raisins, soy sauce, miso soup, yeast/protein extracts, bean curd, fava or broad bean pods, or any over-ripe fruit. Ask your care team for a complete listing of tyramine-containing foods.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medication affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can interfere with the effect of this medication. Avoid alcoholic drinks.

When taking this medication, you may fall asleep without notice. You may be doing activities like driving a car, talking, or eating. You may not feel drowsy before it happens. Contact your care team right away if this happens to you.

There have been reports of increased sexual urges or other strong urges such as gambling while taking this medication. If you experience any of these while taking this medication, you should report this to your care team as soon as possible.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy and drinking plenty of water may help. Contact your care team if the problem does not go away or is severe.

Do not treat yourself for coughs, colds, flu or allergies without asking your care team for advice. Do not take any medications for weight loss without advice either. Some ingredients in these products may increase possible side effects.

If you are diabetic, there is a possibility that this medication may affect your blood sugar. Ask your care team for advice if there is any change in your blood or urine sugar tests.

If you are scheduled for any medical or dental procedure, tell your care team that you are taking this medication. This medication can interact with other medications used during surgery.

You should check your skin often for changes to moles and new growths while taking this medication. Call your care team if you notice any of these changes.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Falling asleep during daily activities
• Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
• Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
• New or worsening uncontrolled and repetitive movements of the face, mouth, or upper body
• Severe increase in blood pressure—sudden, severe headache, nausea, vomiting, stiff neck, fast or irregular heartbeat
• Urges to engage in impulsive behaviors such as gambling, binge eating, sexual activity, or shopping in ways that are unusual for you

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Dizziness
• Drowsiness
• Dry mouth
• Headache
• Nausea
• Pain, irritation, or ulcers in the mouth at application site
• Trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Keep this medication in the original packaging until you are ready to take it. Protect from moisture. Get rid of any unused medication 3 months after opening a pouch. Get rid of any unopened, unused medication after the expiration date.

To get rid of medications that are no longer needed or have expired:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, take the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.