Eldepryl 5 mg 100 tablets — Made in Finland — Free Delivery
(Eldepryl 5 mg)
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Description Eldepryl 5 mg 100 tablets — Made in Finland — Free Delivery
Indications
Parkinson's disease or symptomatic parkinsonism - as monotherapy at an early stage of the disease or in combination with levodopa preparations (in combination with peripheral decarboxylase inhibitors or without them).
Application
Selegiline is used as monotherapy at an early stage of the disease or in combination with levodopa preparations (in combination with peripheral decarboxylase inhibitors or without them). in both cases, the initial dose is 5 mg taken in the morning. the dose of eldepril can be increased to 10 mg / day (can be taken in the morning or divided into two doses).
If, when using the preparation as an adjuvant therapy to levodopa preparations, adverse reactions occur that are predetermined by levodopa, the dose of the latter should be reduced.
Liver failure. There is no information on dose modification in patients with hepatic insufficiency.
Renal failure. There is no information on changing dosage in patients with renal insufficiency.
Contraindications
Hypersensitivity to selegiline or any of the excipients.
Ulcer of the stomach and duodenum in the acute stage.
Simultaneous use with serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors (venlafaxine), tricyclic antidepressants, sympathomimetics, MAO inhibitors (linezolid) or opioids (pethidine) (see Interactions).
When combining selegiline with levodopa, contraindications to the use of levodopa should be taken into account.
Side effects
The frequency of occurrence of adverse reactions has the following classification: very often (≥1 / 10); often (≥1/100, 1/10); infrequently (≥1/1000, 1/100); rarely (≥1/10,000–1/1000); very rarely (1/10,000), the frequency is unknown (cannot be determined from the available data).
Mental disorders: often - confusion, hallucinations; infrequently - mood swings; frequency unknown - disorders of impulse control and coercion (such as hypersexuality).
Nervous system disorders: often - involuntary movements (dyskinesia), dizziness, headache; infrequently - passing sleep disturbances (insomnia); rarely - arousal.
Cardiac disorders: often - bradycardia; infrequently - supraventricular tachycardia; rarely - arrhythmias.
Vascular disorders: rarely - postural hypotension.
Gastrointestinal disorders: often - nausea; infrequently - dry mouth.
On the part of the hepatobiliary system: often - increased levels of liver enzymes.
Skin and subcutaneous tissue disorders: Rarely, rash.
Renal and urinary disorders: rarely - difficulty urinating; frequency unknown - urinary retention.
When using the preparation, there are also such side reactions as psychosis, depression, tremor, pain in the chest, back, joints, throat, vertigo, blurred vision, vomiting, constipation, diarrhea.
When combined with levodopa. Since the preparation enhances the effect of levodopa, the side effects of levodopa (such as restlessness, hyperkinesia, atypical movements, agitation, confusion, hallucinations, postural hypotension, cardiac arrhythmias, dysphonia) may be increased in case of combination therapy (levodopa should usually be used in combination with an inhibitor of peripheral decarboxylase). If, when using the preparation in combination with levodopa preparations, adverse reactions occur that are predetermined by levodopa, the dose of the latter should be reduced. Therefore, with the start of treatment with selegiline, the dose of levodopa can be reduced by an average of 30%.
special instructions
Selegiline in combination with levodopa is especially indicated in patients whose condition changes due to treatment with levodopa preparations at maximum doses (the occurrence of fluctuations as a dose depletion effect).
Special care should be taken when using selegiline in patients with duodenal ulcer, labile hypertension, cardiac arrhythmia, severe angina pectoris, severe hepatic or renal insufficiency, or psychosis.
Since selegiline potentiates the effect of levodopa, adverse reactions due to levodopa may increase, especially against the background of the use of high doses of levodopa. Patients receiving such treatment should be closely monitored. When selegiline is added to levodopa, symptoms such as spontaneous movements and / or arousal may appear, which disappear when the dose of levodopa is reduced. Therefore, with the start of treatment with selegiline, the dose of levodopa can be reduced by an average of 30%.
At high doses (greater than 10 mg/day), the selectivity of selegiline for MAO-B begins to decline, resulting in increased inhibition of MAO-A. Thus, the risk of developing hypertension increases.
In patients taking MAO inhibitors, care should be taken when performing general anesthesia in surgical practice.
Impulse control disorders and compulsive urges such as pathological gambling, increased libido and hypersexuality, bulimia, wastefulness, and other compulsive or repetitive activities have been reported in patients with Parkinson's disease during therapy with dopamine agonists or other dopaminergic preparations, such as selegiline.
Some studies suggest that patients taking both selegiline and levodopa have a higher mortality rate compared to patients taking levodopa alone. But it must be taken into account that these studies revealed numerous methodological weaknesses and that meta-analysis and large cohort studies concluded that there is no significant difference between the mortality rate of patients who received selegiline and patients who received comparators or the combination of selegiline/levodopa. statistically significant difference.
The combination of selegiline and levodopa is not appropriate in patients with dose-independent changes in response to treatment.
Caution should be exercised when selegiline is combined with preparations that act predominantly on the central nervous system.
The simultaneous use of selegiline with alcohol should be avoided.
Use during pregnancy and lactation. Since the available data on the safety of the use of selegiline during pregnancy and lactation is not enough, selegiline should not be used in this category of patients.
Children. There is no information on the use of the preparation in children, so the use of the preparation in this category of patients is not indicated.
The ability to influence the reaction rate when driving vehicles or working with other mechanisms. The effect of selegiline on the ability to drive or use machines has not been studied. Dizziness may occur during treatment with selegiline. In such cases, you should refrain from driving vehicles or working with other mechanisms.
Interactions
The following combinations are contraindicated
Sympathomimetics. Simultaneous use of selegiline with sympathomimetics can lead to severe hypertension.
Pethidine. The simultaneous use of selegiline (a selective MAO inhibitor) and pethidine is contraindicated. It is known that selegiline and pethidine interact with each other with a potentially fatal outcome, but the mechanism of this interaction has not yet been studied.
Tramadol may also interact with selegiline.
Selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors (venlafaxine). When fluoxetine is combined with selegiline, increased sweating, hyperemia, ataxia, tremor, hyperthermia, arterial hyper- and hypotension, convulsions, accelerated heartbeat, dizziness, agitation, confusion, hallucinations, delirium and coma may be noted. Since fluoxetine and its active metabolites have a long half-life, at least 5 weeks should elapse between fluoxetine withdrawal and initiation of selegiline therapy. Selegiline and its metabolites have a short half-life, so a 2-week interval is sufficient between the withdrawal of selegiline and the start of fluoxetine.
Tricyclic antidepressants. When selegiline is combined with tricyclic antidepressants, toxic effects from the central nervous system (dizziness, tremor, convulsions) may occur; sometimes - arterial hyper- or hypotension, increased sweating. Since the mechanism of these reactions is not well understood, the simultaneous use of selegiline and tricyclic antidepressants is contraindicated.
MAO inhibitors. The use of MAO inhibitors simultaneously with selegiline may lead to severe arterial hypotension or hypertension.
Combinations not recommended
Oral contraceptives. Caution should be exercised when using selegiline with combined oral contraceptives (gestagen/ethinylestradiol or levonorgestrel/ethinylestradiol) as they may increase the bioavailability of selegiline.
Interaction with food. Unlike traditional MAO inhibitors, which inhibit both MAO-A and MAO-B, selegiline is a selective MAO-B inhibitor.
When using selegiline at the recommended doses after eating food with a low content of tyramine, no hypertensive reaction (the so-called cheese effect) was detected. Therefore, in this case, there is no need to follow a diet.
However, when selegiline is combined with traditional MAO inhibitors or MAO-A inhibitors, it is recommended to strictly adhere to the diet (avoid foods high in tyramine - mature cheese and products containing yeast).
Overdose
There are no data on clinically significant preparation overdose. The effect of selegiline as a selective MAO-B inhibitor is achieved when used at doses recommended for the treatment of Parkinson's disease (5–10 mg/day). symptoms of overdose may be similar to those of overdose with non-selective MAO inhibitors (such as drowsiness, dizziness, irritability, agitation, hyperactivity, tremor, restlessness, severe muscle spasms, severe headache, hallucinations, hypertension, arterial hypotension, chest pain, accelerated and uneven pulse, circulatory collapse, respiratory failure, respiratory depression, increased sweating, hyperthermia, coma, convulsions). Overdose symptoms may develop within 24 hours. There is no specific antidote, treatment is symptomatic.
Storage conditions
At room temperature 15–25 °C.
Tags: Eldepryl
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