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Uses

What is Zelapar used for?

Zelapar (selegiline) is commonly used to treat Parkinson’s disease, a condition that affects the part of your brain that controls your movements.

Zelapar may also be used for other conditions as determined by your healthcare provider.

How does Zelapar work (mechanism of action)?

Zelapar belongs to a group of medicines called monoamine oxidase inhibitors (MAOI). It is believed to increase the amount of a natural chemical called dopamine in the brain, which helps alleviate the movement-related symptoms of Parkinson’s disease.

How is Zelapar supplied (dosage forms)?

Zelapar is available in the following dosage form that is taken by mouth.

  • 1.25 mg orally disintegrating tablets

How should I store Zelapar?

Zelapar should be stored at room temperature (77 F or 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Keep the tablet inside the blister pack, and keep the blister pack inside the sachet pouch until ready to use. Store the sachet pouch inside the clear child-resistant pouch provided. Use within 3 months of opening the sachet pouch.

Side Effects

What are the most common side effects of Zelapar?

The most common side effects of Zelapar are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Constipation
  • Skin problems
  • Vomiting
  • Dizziness
  • Uncontrollable, involuntary movements (see below)
  • Trouble sleeping
  • Shortness of breath
  • Muscle pain
  • Rash

There may be other side effects of Zelapar that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Zelapar?

While less common, the most serious side effects of Zelapar are described below, along with what to do if they happen.

Severe Allergic Reactions. Zelapar may cause allergic reactions, which can be serious. Stop taking Zelapar and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Increased Blood Pressure (Hypertension). Zelapar may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your healthcare provider if your blood pressure increases while taking this medicine.

If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable but look out for any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea/vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Serotonin Syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Zelapar can cause serotonin syndrome when it is taken alone or with other medicines that affect serotonin. This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.

  • Sweating, fever, or flushing
  • Confusion
  • Feeling agitated or restless
  • Seeing or hearing unusual things
  • Dizziness
  • Fast or racing heartbeat
  • Nausea, vomiting, or diarrhea
  • Muscle twitching, stiffness, or tremor
  • Seizures

Sleepiness. Zelapar can make you sleepy, sometimes very suddenly and without warning signs. Do not drive or do other activities that require alertness or coordination until you know how Zelapar affects you.

Low Blood Pressure Upon Standing (Orthostatic Hypotension). Zelapar may cause a sudden drop in blood pressure when standing up from a seated or lying position. To help prevent this, be careful not to get up too quickly. If you feel dizzy, sit or lie down right away until the dizziness stops, then take your time getting up again. Tell your healthcare provider right away if you have any of the following symptoms of orthostatic hypotension.

  • Dizziness, feeling lightheaded, or fainting upon standing
  • Blurred vision
  • Confusion
  • Feeling weak

Uncontrollable, Involuntary Movements (Dyskinesia). Zelapar may cause involuntary movement problems, including shakiness, stiffness, or jerkiness. Call your healthcare provider right away if you develop any unusual or uncontrolled movements.

Hallucinations or Psychotic-like Behaviors. Zelapar may cause hallucinations or psychotic-like behaviors. Tell your healthcare provider right away if you experience any of the following (either you have noticed on your own or you have been told by others).

  • Hearing, seeing, smelling, tasting, or otherwise perceiving things that have turned out to be false
  • Delusional thoughts (such as false belief that you are being controlled)
  • Disorganized thoughts (such as jumping between topics or having a hard time focusing)
  • Sudden decline in self-care (such as personal hygiene or academic/work performances)

Unusual or Compulsive Behaviors. Zelapar can cause some people to have strong unusual and uncontrolled urges (compulsions), including gambling, sex, shopping, or eating. Talk to your healthcare provider right away if you or someone you know notices that you have new or worsening strong urges or behaviors.

Warnings & Precautions

Who should not use Zelapar?

Allergies to Ingredients. People who are allergic to any of the following should not take Zelapar.

  • Selegiline
  • Zelapar
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Zelapar.

Liver Problems. Zelapar should not be taken if your liver is not working as well as it should be. If there is a concern about the health of your liver, your healthcare provider may do tests to determine if it is working well enough to take this medicine.

Kidney Problems. Zelapar should not be taken if your kidneys are not working as well as they should be. If there is a concern about the health of your kidneys, your healthcare provider may do tests to determine if they are working well enough to take this medicine.

Drug Interactions. Zelapar should not be taken while you are using certain other medicines. Before taking Zelapar, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about Zelapar before using it?

Do not take Zelapar unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share Zelapar with other people, even if they have the same condition as you. It may harm them.

Keep Zelapar out of the reach of children.

Do not stop taking Zelapar without talking to your healthcare provider. Stopping too quickly may cause serious side effects. Call your healthcare provider right away if you have any of the following symptoms.

  • High fever
  • Muscle stiffness or rigidity, where it is hard to move
  • Changes in your breathing or heart rate
  • Increased sweating
  • Confusion

Zelapar may cause you to feel sleepy, especially if you already have conditions that can make you drowsy. You may feel sudden drowsiness in the middle of an activity without warning signs. Zelapar may also cause dizziness, especially when you stand up quickly after lying or sitting down. Do not drive or do other activities that require alertness or coordination until you know how Zelapar affects you.

Zelapar can cause irritation in your mouth that may include mouth pain, swallowing pain, reddening, or ulcers. Tell your healthcare provider if you experience any bothersome side effects in your mouth.

Take Zelapar before breakfast and without any liquid. Avoid eating food or drinking liquid for 5 minutes before and after taking a dose.

Do not push the Zelapar tablet through the foil back of the blister pack. Instead, peel back the foil and gently remove the tablet using dry hands, and place it on your tongue right away. 

People who are 65 years of age or older can be at greater risk for some side effects from Zelapar. Talk to your healthcare provider about your risks if you are in this age group.

What should I tell my healthcare provider before using Zelapar?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Zelapar is right for you.

In particular, make sure that you discuss any of the following.

Psychotic Disorder. Tell your healthcare provider if you have any psychotic disorder such as schizophrenia or delusional disorder. Zelapar may increase the risk of psychosis.

Sleepiness. Tell your healthcare provider if you have any conditions that make you more sleepy than usual or if you feel that you are prone to feeling drowsy during the day. Zelapar may increase the risk of sudden daytime drowsiness.

Phenylketonuria (PKU). Zelapar orally disintegrating tablets contain aspartame, which can be dangerous for people with phenylketonuria. Tell your healthcare provider if you have PKU and are prescribed Zelapar.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • High or low blood pressure
  • Uncontrollable, involuntary movements (dyskinesia)
  • Unusual urges
  • Liver problems
  • Kidney problems

Pregnancy. It is not known if or how Zelapar could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. It is not known if Zelapar passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop Zelapar.

How can I get more information about Zelapar?

For more information about Zelapar, you can visit the manufacturer’s website at www.bauschhealth.com or call them at 800-321-4576.

Interactions

Does Zelapar interact with foods or drinks?

Zelapar can increase your body’s sensitivity to tyramine, a natural compound found in large amounts in foods such as aged cheese, cured or processed meat, pickled or fermented vegetables, citrus and tropical fruits, and fermented alcoholic beverages such as beer or red wine. Avoid eating foods high in tyramine while taking Zelapar, as this may increase the risk of large increases in your blood pressure.

It is unknown if drinking alcohol will affect Zelapar. The risk of drowsiness may be increased if you drink alcohol while taking Zelapar. Certain alcoholic beverages, such as beer or red wine, should be avoided due to their high tyramine contents.

Does Zelapar interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking Zelapar.

  • An opioid, such as meperidine, tramadol, or methadone within the past 2 weeks, which is a medicine used for certain types of pain 
  • Another monoamine oxidase inhibitor (MAOI) within the past 2 weeks, which is a medicine usually used for depression or Parkinson’s disease
  • Linezolid within the past 2 weeks, which is a medicine used for bacterial infections
  • Cyclobenzaprine, which is a muscle relaxant
  • St. John’s wort, which is a supplement that may be used to treat depression
  • Dextromethorphan, which is a cough suppressant contained in many prescription and OTC products for cold and flu symptoms
  • Ephedrine, which is a medicine used to relieve symptoms of asthma
  • An antidepressant, such as a tricyclic antidepressant (TCA), a selective serotonin reuptake inhibitor (SSRI), or a serotonin norepinephrine reuptake inhibitor (SNRI) within the past 2 weeks (5 weeks if the antidepressant was fluoxetine), which is a medicine that is commonly used for depression
  • Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
  • Carbamazepine (Tegretol, Carbatrol, and others), which is a medicine commonly used to treat seizures or nerve pain
  • Phenobarbital, which is a medicine that may be used to treat insomnia or seizures
  • Nafcillin, which is an antibiotic used to treat bacterial infections
  • Rifampin, which is a medicine commonly used to treat an infection called tuberculosis
  • An antipsychotic, which is a medicine for certain mental health conditions
  • Metoclopramide (Reglan and others), which is a medicine for acid reflux or a problem where your stomach takes too long to empty

Some other medicines may alter the blood levels of Zelapar. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Zelapar. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Zelapar?

If you or someone else has used too much Zelapar, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Zelapar?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.