Worst Pills, Best Pills

An expert, independent second opinion on more than 1,800 prescription drugs, over-the-counter medications, and supplements

Drug Profile

The information on this site is intended to supplement and enhance, not replace, the advice of a physician who is familiar with your medical history. Decisions about your health should always be made ONLY after detailed conversation with your doctor.

Limited Use [what does this mean?]
Generic drug name: selegiline/deprenyl [oral] (sell EDGE ell lean)
Brand name(s): ELDEPRYL, ZELAPAR
GENERIC: available FAMILY: Drugs for Parkinson’s Disease
Find the drug label by searching at DailyMed.

Pregnancy and Breast-feeding Warnings [top]

Pregnancy Warning

Selegiline caused fetal harm in animal studies, including a decrease in body weight and pup survival after birth. Because of the potential for serious adverse effects to the fetus, this drug should not be used by pregnant women.

Breast-feeding Warning

No information is available from either human or animal studies. It is likely that this drug, like many others, is also excreted in human milk, and because of the potential for serious adverse effects in nursing infants, you should not take this drug while nursing.

Safety Warnings For This Drug [top]

Beware of Compounding Pharmacists

Selegiline, or deprenyl, is being promoted by compounding pharmacists to improve memory, slow the loss of sexual capacity, and increase life span.

Drugs compounded by pharmacists are not FDA-approved. They have not been shown to be safe or effective for use and are produced in facilities that do not have to meet Good Manufacturing Practice guidelines.

Facts About This Drug [top]

Selegiline (ELDEPRYL) is approved by the Food and Drug Administration (FDA) as an adjunct in the management of Parkinson’s disease in patients being treated with levodopa and carbidopa (SINEMET, SINEMET CR) who exhibit deterioration in the quality of their response to this treatment. There is no evidence from controlled studies that selegiline has any beneficial effect in the absence of concurrent levodopa therapy.[1]

Selegiline belongs to a group of drugs called monoamine oxidase (MAO)...

Selegiline (ELDEPRYL) is approved by the Food and Drug Administration (FDA) as an adjunct in the management of Parkinson’s disease in patients being treated with levodopa and carbidopa (SINEMET, SINEMET CR) who exhibit deterioration in the quality of their response to this treatment. There is no evidence from controlled studies that selegiline has any beneficial effect in the absence of concurrent levodopa therapy.[1]

Selegiline belongs to a group of drugs called monoamine oxidase (MAO) inhibitors. In order to reduce side effects, it is a good practice to start with a low dose of selegiline, and then increase the dose gradually.[2],[3]

Rare cases of hypertensive reactions associated with ingestion of tyramine-containing foods have been reported in patients taking the recommended daily dose of selegiline.[4]

Originally, selegiline was thought to be most useful in the early stages of Parkinson’s disease to slow the advance of the disease and to delay the need to institute levodopa. This practice has not proved to be effective.[5] Now selegiline is used only as adjunctive treatment in some patients.

Selegiline is not recommended for those in the advanced stages of Parkinson’s disease or with dementia.[6],[3] Mental side effects are of special concern in the elderly.[7]

Avoid drug-induced disease

If you have symptoms of parkinsonism (tremor, rigid muscles and disturbances in posture, walking, balance, speech, swallowing and muscle strength), there is a good chance that they are caused by a drug you are taking. As many as half of older adults with symptoms of parkinsonism may have developed them as adverse effects of a drug. (See the section that lists drugs that can cause symptoms of parkinsonism.)

If you take any of the drugs on this list, discuss the possibility of drug-induced parkinsonism with your doctor and ask to have your prescription changed or stopped.

Regulatory actions surrounding selegiline

2009: The patient package insert for selegiline has been updated to include information on reports of an intense urge to gamble, increased sexual urges and other intense urges (and the inability to control these urges) in patients using this drug. In some cases the urges were stopped when the drug was decreased or stopped. However it has not been proven that the drug caused these events.[8]

Before You Use This Drug [top]

Tell your doctor if you have or have had:

  • pregnancy or are breast-feeding
  • allergy to selegiline
  • stomach ulcers
  • excessive tremor
  • profound dementia
  • severe mental problems
  • uncontrolled movements of tongue, lips, face, trunk, or extremities

Tell your doctor about any other drugs you take, including aspirin, herbs, vitamins, and other nonprescription products.

When You Use This Drug [top]

  • If taking 20 milligrams or more of selegiline a day, avoid tyramine-containing foods, such as aged cheese, fava or broad bean pods, yeast/protein extracts, smoked or pickled meats—including fish and poultry, bologna, pepperoni, salami, summer sausagefermented meat, sauerkraut, overripe fruit, beer, reduced-alcohol and alcohol-free beer and wine, red and white wines, sherry, liqueurs.
  • Avoid alcoholic beverages.
  • Avoid large quantities of caffeine-containing drinks.
  • Avoid nonprescription cough and cold drugs.
  • Avoid the painkiller meperidine (DEMEROL).
  • Be cautious when getting up suddenly.
  • Check with your doctor or hospital emergency room if you have a hypertensive crisis: severe chest pain, enlarged pupils, fast or slow heartbeat, severe headache, increased sweating (possible with fever or cold), clammy skin, nausea or vomiting, stiff or sore neck.
  • If mouth is dry, use sugarless candy or gum, ice, or saliva substitute. If dry mouth continues for more than two weeks, check with doctor or dentist.
  • If you discontinue this drug, the preceding dietary restrictions must be continued for at least two weeks.

How to Use This Drug [top]

  • If you miss a dose, take it as soon as you remember, but skip it if it is almost time for the next dose. Do not take double doses.
  • Do not share your medication with others.
  • Take the drug at the same time(s) each day.
  • Store at room temperature with lid on tightly. Do not store in the bathroom. Do not expose to heat, moisture, or strong light. Keep out of reach of children.

Interactions with Other Drugs [top]

The following drugs, biologics (e.g., vaccines, therapeutic antibodies), or foods are listed in Evaluations of Drug Interactions 2003 as causing “highly clinically significant” or “clinically significant” interactions when used together with any of the drugs in this section. In some sections with multiple drugs, the interaction may have been reported for one but not all drugs in this section, but we include the interaction because the drugs in this section are similar to one another. We have also included potentially serious interactions listed in the drug’s FDA-approved professional package insert or in published medical journal articles. There may be other drugs, especially those in the families of drugs listed below, that also will react with this drug to cause severe adverse effects. Make sure to tell your doctor and pharmacist the drugs you are taking and tell them if you are taking any of these interacting drugs:

ALPHAGAN P, brimonidine, bupropion, CELEXA, citalopram, COMTAN, DELSYM, DEMEROL, dextromethorphan, entacapone, fluoxetine, imipramine, IMITREX, meperidine, MERIDIA, mirtazapine, nefazodone, PROZAC, reboxetine, REMERON, SERZONE, sibutramine, sumatriptan, TOFRANIL, tramadol, ULTRAM, WELLBUTRIN, ZYBAN.

Adverse Effects [top]

Call your doctor immediately if you experience:

  • increase in unusual body movements
  • mood or other mental changes
  • new, increased, or severe chest pain
  • irregular heartbeat
  • wheezing, breathing difficulty, or tightness in chest
  • swelling of feet or lower legs
  • difficulty speaking
  • loss of balance control
  • uncontrolled movements, especially of face, neck, arms, legs, and back
  • restlessness or desire to keep moving
  • twisting body movements
  • bloody or black, tarry stools
  • severe stomach pain
  • vomiting blood or vomit that looks like coffee grounds
  • hallucinations
  • severe headache
  • severe high blood pressure
  • dizziness or lightheadedness
  • difficult or frequent urination
  • lip smacking or puckering
  • puffing of cheeks
  • rapid or wormlike movements of tongue
  • uncontrolled chewing movements
  • enlarged pupils
  • fast or slow heartbeat
  • increased sensitivity of eyes to light
  • increased sweating, possibly with fever or cold, clammy skin
  • severe nausea or vomiting
  • stiff or sore neck

Call your doctor if these symptoms continue:

  • abdominal or stomach pain
  • dizziness or faintness
  • dry mouth
  • trouble sleeping
  • nausea or vomiting
  • anxiety, nervousness, or restlessness
  • increased inability to move
  • sudden closing of eyelids
  • blurred or double vision
  • body aches or back or leg pain
  • slowed movements
  • chills
  • constipation or diarrhea
  • increased sweating
  • drowsiness
  • headache
  • heartburn
  • high or low blood pressure
  • impaired memory
  • slow or difficult urination
  • frequent urge to urinate
  • irritability
  • appetite loss
  • weight loss
  • muscle cramps or numbness of fingers or toes
  • fast or pounding heartbeat
  • burning lips or mouth
  • burning in throat
  • increased sensitivity of skin and eyes to sunlight
  • skin rash
  • ringing or buzzing in ears
  • changes in sense of taste
  • unusual feeling of well-being
  • unusual tiredness or weakness
  • teeth grinding, clenching, or gnashing
  • sudden jerky body movements

Signs of overdose:

  • agitation or irritability
  • chest pain
  • convulsions
  • cool, clammy skin
  • increased sweating
  • severe dizziness or faintness
  • fast or irregular pulse
  • high or low blood pressure
  • high fever
  • severe spasm where head and heels are bent backward and the body arches forward
  • troubled breathing
  • lockjaw

If you suspect an overdose, call this number to contact your poison control center: (800) 222-1222.

last reviewed December 31, 2020