Eldepryl
In brief
- Eldepryl (selegiline) is a prescription-only medicine in the UK and is supplied via pharmacies or hospital prescriptions.
- Eldepryl is used mainly as an adjuvant treatment for Parkinson’s disease; it is a selective monoamine oxidase B (MAO-B) inhibitor that increases central dopamine availability and may help reduce “wearing-off” symptoms when used with levodopa/carbidopa.
- The usual adult dose for Parkinson’s is 5–10 mg daily (commonly 5 mg twice daily); orally disintegrating tablets (ODT) are used at lower strengths (about 1.25–2.5 mg once daily). Doses may be adjusted when used with levodopa.
- Administration forms include oral tablets (5 mg, 10 mg), capsules (5 mg), orally disintegrating tablets (Zelapar 1.25 mg); Eldepryl is usually given orally as tablet or capsule.
- Pharmacological action begins within hours of a dose, but meaningful symptomatic improvement for Parkinson’s disease is often noticed over days to several weeks of treatment.
- Although the plasma half-life of selegiline is relatively short, its irreversible inhibition of MAO‑B produces effects that persist for about 24 hours after dosing.
- Avoid excessive alcohol while taking selegiline: alcohol can worsen dizziness, drowsiness and orthostatic effects and some alcoholic/fermented drinks may be high in tyramine, increasing the risk of hypertensive reactions.
- The most common side effect is nausea; other frequent adverse effects include dry mouth, dizziness, insomnia, headache, abdominal pain and increased sweating.
- Would you like to try Eldepryl without a prescription?
Basic Eldepryl information
- INN (international nonproprietary name): Selegiline.
- Brand names available in the United Kingdom: Eldepryl — tablets 5 mg and 10 mg supplied in blister packs of 28 or 100; generic selegiline.
- ATC code: N04BD01 (Monoamine oxidase B inhibitors; anti-parkinson drugs).
- Forms and dosages: Tablets 5 mg and 10 mg (blisters 28, 100); capsules 5 mg; orally disintegrating tablets 1.25 mg (Zelapar).
- Registration status in the United Kingdom: authorised by the MHRA for anti‑parkinson treatment; prescription-only medicine (POM).
- OTC / Rx classification: Prescription-only medicine (POM)
Legal status and availability in the UK
Eldepryl (selegiline) is a prescription-only medicine (POM) in the UK.
In our online pharmacy, Eldepryl is available without a prescription, with discreet delivery to the United Kingdom in 9–21 days.
Indications and practical use
Licensed indications
- Adjunctive treatment for Parkinson’s disease
- Typical dose: 5–10 mg daily, often 5 mg twice daily.
- Expected effect: improved dopaminergic tone and delay in levodopa dose escalation.
- Monitoring: review at 2–6 weeks for symptomatic response and side effects.
- With levodopa/carbidopa
- Typical dose: same as above, with dose adjustments of levodopa as required.
- Expected effect: reduced wearing-off episodes.
- Monitoring: check for increased dyskinesia and orthostatic hypotension.
Off-label and related uses
Some agents in this class have research-level indications. Off-label enquiries should always be directed to the prescriber or a neurologist.
Product forms, dosages and packaging
Forms and strengths
| Form | Strengths | Typical packaging |
|---|---|---|
| Tablet | 5 mg, 10 mg | Blister packs 28, 100 |
| Capsule | 5 mg | Blister packs (variable) |
| Orally disintegrating tablet (Zelapar) | 1.25 mg | Blister packs |
Practical notes
- Dosing schedules are commonly 5 mg twice daily for tablets; ODT dosing differs (1.25–2.5 mg once daily).
- Do not crush or chew tablets unless the product is an ODT formulation designed to dissolve on the tongue.
- Check for contraindicated co-medications (e.g. other MAOIs, certain opioids) and relevant allergies.
Practical dosing guidance and titration
Standard regimens for Parkinson’s
How are the commonly used doses best explained to patients?
Standard adult dosing for Parkinson’s disease is 5–10 mg daily, most often split as 5 mg twice daily when tablets or capsules are used.
For orally disintegrating formulations, typical doses are 1.25–2.5 mg once daily.
Morning dosing is advised when insomnia occurs; confirm whether the prescriber intended once‑daily or divided dosing.
Titration schedules and real-world tips
Typical titration steps:
| Step | Action |
|---|---|
| Start | Begin at 5 mg once daily (or 1.25 mg ODT) and monitor for tolerance. |
| Up-titrate | Increase to 5 mg twice daily if needed after 2–4 weeks. |
| Max | Consider up to 10 mg daily for tablets/capsules; document response and side effects. |
| Follow-up | Arrange review at 2–8 weeks and communicate any concerns to the prescriber. |
Patient counselling points: do not stop abruptly, take ODT by dissolving on the tongue, move dosing to morning if insomnia develops, seek urgent care for severe hypertension or hallucinations.
Contraindications, drug interactions and food safety
Absolute and relative contraindications
| Contraindication | Action required |
|---|---|
| Hypersensitivity to selegiline or excipients | Do not dispense; advise prescriber and document allergy. |
| Concomitant use with other MAOIs or pethidine | Contraindicated; contact prescriber urgently. |
| Pheochromocytoma | Contraindicated due to hypertensive crisis risk. |
| Severe cardiovascular disease | Use with caution; liaise with prescriber and monitor blood pressure closely. |
Key drug interactions and food cautions
Which interactions and food cautions should be front-of-mind?
Warn about serotonergic agents such as SSRIs and SNRIs, and certain triptans because of serotonin syndrome risk when combined with selegiline.
Sympathomimetics and some anaesthetics require caution because of potential hypertensive effects.
Although selective MAO‑B inhibition reduces tyramine risk at usual doses, patients should still be aware of tyramine-rich foods such as aged cheese and cured meats to avoid hypertensive episodes.
Side-effect profile and monitoring
Common and clinically significant adverse effects
- Common adverse effects include nausea, dry mouth, dizziness, insomnia, headache and increased sweating.
- Clinically significant concerns include orthostatic hypotension, agitation and hallucinations, particularly in frail or polypharmacy patients.
- Document any reports of behavioural change, falls or worsening cognition and relay to the prescriber.
Monitoring schedule and red flags
What monitoring is recommended and what triggers urgent action?
Baseline blood pressure assessment is useful where available, and routine check-ins at 2–4 weeks after starting or after dose changes are recommended.
Advise patients to seek urgent review for severe hypertension, agitation, convulsions or signs of serotonin syndrome such as rapid changes in mental status and high temperature.
Report suspected adverse reactions to the MHRA Yellow Card scheme and document the discussion in the patient record.
Combining Eldepryl with levodopa and polypharmacy management
Practical benefits and pitfalls
Does combining selegiline with levodopa help and what should be watched for?
Eldepryl is commonly used as an adjunct to levodopa/carbidopa to reduce wearing-off and to allow lower levodopa doses where appropriate.
Benefits include smoother motor control and potential delay of levodopa escalation.
Pitfalls include possible increased dopaminergic side effects such as dyskinesia and compounded orthostatic hypotension when combined with antihypertensives.
Dosing coordination with levodopa/carbidopa
| Timeline | Action |
|---|---|
| Baseline | Record current levodopa dose and symptom pattern. |
| Introduce Eldepryl | Start 5 mg once daily, review response in 2–6 weeks. |
| Adjustment | Consider levodopa dose reduction if dyskinesia increases or to optimise benefit. |
| Follow-up | Offer pill synchronisation and compliance aids to improve adherence. |
Common co-prescribed Parkinson’s drugs include dopamine agonists, COMT inhibitors and other MAO‑B inhibitors; any combination should prompt prescriber communication.
Dosing adjustments: elderly, hepatic/renal impairment and paediatrics
Age-related considerations
How should dosing differ for older patients?
Elderly patients may have increased sensitivity to selegiline and should usually start at the lower end of the adult dosing range with careful titration and close monitoring.
Watch for increased dizziness, sedation and hallucinations that may require dose reduction.
Consider ODT forms if swallowing difficulty is an issue and liaise with prescribers about suitability for compliance aids.
Organ impairment and special populations
What about liver or kidney impairment and children?
Use selegiline with caution in hepatic or renal impairment because reduced clearance can increase exposure and adverse effects.
No paediatric dosing is established and use in children is not recommended.
Check recent renal and hepatic function where available and review the dose after any clinically relevant change; start low and monitor closely.
Storage, handling and expiry
Shelf life and storage conditions
| Item | Instruction |
|---|---|
| Storage temperature | Store in original packaging at room temperature below 25°C. |
| Moisture and light | Keep away from moisture and direct light; do not refrigerate or freeze. |
| Expiry checks | Do not use discoloured or damaged tablets or tablets past their expiry date. |
Handling and patient counselling
Check blister integrity, batch number and expiry date before use.
Advise patients to store medicines in original packs, keep out of reach of children and return unwanted medicines to the pharmacy for safe disposal.
Signs of overdose include severe hypertension, agitation or convulsions; seek immediate medical attention.
Missed dose, overdose management and emergency advice
Practical missed-dose guidance
What should patients do if they miss a dose?
Take the missed dose as soon as remembered unless it is nearly time for the next scheduled dose.
Do not double up doses to make up for a missed dose.
Overdose response and triage
What to do if an overdose is suspected.
Overdose can cause severe hypertension, agitation, convulsions, hallucinations and potentially life-threatening complications.
If an overdose is suspected, call 999 or go to A&E and provide details of the dose taken, the time and any other medicines.
Emergency department actions typically include blood pressure control, benzodiazepines for agitation and monitoring for serotonin syndrome.
Document incidents and report suspected adverse reactions via the MHRA Yellow Card scheme.
Alternatives to selegiline
Key alternatives and comparative notes
| Product | Mechanism | Dosing frequency |
|---|---|---|
| Rasagiline | MAO‑B inhibitor | Once daily |
| Safinamide | Reversible MAO‑B inhibitor | Once daily |
| Entacapone | COMT inhibitor | With each levodopa dose |
Rasagiline’s once-daily dosing may favour adherence, while selegiline is a well-established option with generics available.
Regulatory status
Selegiline is prescription only in the United Kingdom and is authorised by the MHRA.
It is classified under ATC code N04BD01 as an MAO‑B inhibitor for anti‑parkinson use.
Delivery across the United Kingdom
| City | Region | Delivery time |
|---|---|---|
| London | England | 9–21 days |
| Birmingham | England | 9–21 days |
| Manchester | England | 9–21 days |
| Glasgow | Scotland | 9–21 days |
| Leeds | England | 9–21 days |
| Sheffield | England | 9–21 days |
| Liverpool | England | 9–21 days |
| Edinburgh | Scotland | 9–21 days |
| Bristol | England | 9–21 days |
| Newcastle Upon Tyne | England | 9–21 days |
| Nottingham | England | 9–21 days |
| Belfast | Northern Ireland | 9–21 days |
| Cardiff | Wales | 9–21 days |
| Leicester | England | 9–21 days |
