Drug
Selegiline
Pronounced
"seh-LEDGE-uh-leen"
Drug Interactions
See also How to Use section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with selegiline include: antidepressants (including bupropion, maprotiline, mirtazapine), other MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, tranylcypromine), appetite suppressants (such as diethylpropion), drugs for attention deficit disorder (such as atomoxetine, methylphenidate), apraclonidine, buspirone, carbamazepine/oxcarbazepine, cyclobenzaprine, deutetrabenazine, certain herbal products (such as ephedra/ma huang), cold medications/nasal decongestants (such as phenylephrine, phenylpropanolamine, pseudoephedrine), fentanyl, metoclopramide, street drugs (such as LSD, mescaline), stimulants (such as amphetamines, ephedrine), supplements (such as tryptophan, tyramine), tetrabenazine, certain "triptans" used to treat migraine headaches (such as rizatriptan, sumatriptan, zolmitriptan), valbenazine.
The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, dextromethorphan, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine, TCAs such as amitriptyline/doxepin), certain opioid medications (such as meperidine, methadone, pentazocine, propoxyphene, tramadol, tapentadol), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.
Tell your doctor or pharmacist if you are using any of these medications before, during, or within 2 weeks after treatment with selegiline. Tell your doctor or pharmacist if you have taken fluoxetine during at least 5 weeks before starting selegiline. Discuss with your doctor how much time to wait between starting or stopping any of these drugs and taking selegiline.
Check the labels on all your medicines (such as allergy, cough-and-cold products, diet pills) because they may contain dextromethorphan, decongestants, or stimulants. Ask your pharmacist about the safe use of those products.
This medication may interfere with certain medical/lab tests (such as brain scan for Parkinson's disease), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.
Negative Interactions
2- Potential Negative Interaction
Selegiline
Ephedra
Ephedrine is an active ingredient found in ephedra, an herb that until 2004 was used in cold remedies and herbal weight loss products. One individual taking selegiline together with ephedrine experienced a serious side effect known as hypertensive crisis, in which blood pressure can reach dangerous levels. Though no studies have investigated whether the herb ephedra might result in similar effects, the current evidence suggests that people taking selegiline should avoid all products that contain ephedra.
EphedraSelegiline- Sifton DW, ed. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1025-7.
- Potential Negative Interaction
Selegiline
Scotch Broom
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
Scotch broom contains high levels of tyramine. Combining phenelzine and Scotch broom may cause MAOI-type reactions (diarrhoea, flushing, sweating, pounding chest, dangerous changes in blood pressure, and other symptoms). It is important for people taking phenelzine to avoid Scotch broom. People with questions about phenelzine and Scotch broom should ask their doctor.
Scotch BroomSelegiline- Brinker F. Interactions of pharmaceutical and botanical medicines. J Naturopathic Med 1997;7(2):14-20.
Supportive Interactions
2- Replenish Depleted Nutrients
Selegiline
Vitamin B6
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
Phenelzine has a chemical structure similar to other drugs (isoniazid and hydralazine) that can cause vitamin B6 deficiency. One case of phenelzine-induced vitamin B6 deficiency has been reported. Little is known about this interaction. People taking phenelzine should ask their doctor about monitoring vitamin B6 levels and considering supplementation.
Vitamin B6Selegiline- Heller CA, Friedman PA. Pyridoxine deficiency and peripheral neuropathy associated with long-term phenelzine therapy. Am J Med 1983;75:887-8.
- Support Medicine
Selegiline
L-Tryptophan
Both L-tryptophan and 5-HTP have been used to treat depression. One controlled study showed that taking selegiline at the same time as 5-HTP enhanced the antidepressant effect when compared with 5-HTP alone. Further research is needed to determine whether taking selegiline and 5-HTP together might result in unwanted side effects.
L-TryptophanSelegiline- Mendlewicz J, Youdim MB. Antidepressant potentiation of 5-hydroxytryptophan by L-deprenil in affective illness. J Affect Disord 1980;2:137-46.
Explanation Required
1- Needs Explanation
Selegiline
5-HTP
Both L-tryptophan and 5-HTP have been used to treat depression. One controlled study showed that taking selegiline at the same time as 5-HTP enhanced the antidepressant effect when compared with 5-HTP alone. Further research is needed to determine whether taking selegiline and 5-HTP together might result in unwanted side effects.
5-HTPSelegiline- Mendlewicz J, Youdim MB. Antidepressant potentiation of 5-hydroxytryptophan by L-deprenil in affective illness. J Affect Disord 1980;2:137-46.