Major Drug Class: Antidyskinetic

1. Description: Eldepryl works by helping to conserve the amount of dopamine available by preventing the dopamine from being destroyed. While controversial, there is some evidence that this drug may slow the progression of Parkinson's disease, particularly early in the course of the disease. This drug is well-tolerated by most people, so many experts recommend using it despite the controversies.

2. Eldepryl: Eldepryl is used to treat Parkinson's disease. Parkinson's disease is associated with low levels of a chemical called dopamine (doe PA meen) in your brain. The exact way that eldepryl works is unknown. However, it is believed that eldepryl prevents the breakdown of dopamine in your brain. Eldepryl is usually added to a treatment regimen after levodopa / carbidopa therapy begins to deteriorate.

Eldepryl is also used to treat the stiffness, tremors, spasms, and poor muscle control of Parkinson's disease. It is also used to treat the same muscular conditions when they are caused by drugs such as chlorpromazine (Thorazine), fluphenazine (Prolixin), perphenazine (Trilafon), and others. Eldepryl may also be used for purposes other than those listed in this medication guide.

3. Drug Mechanism: Eldepryl provides selective protection against the age-related degeneration of the dopaminergic nervous system. It protects sensitive dopamine-containing neurons from the age-associated increases in glial cells (non-neuron brain cells) and the monoamine oxidase (type B) that they contain. Eldepryl is the first selective inhibitor of MAO-B ever discovered, it is the only one used in clinical practice, and it remains the scientific reference standard for B-type inhibition after more than 40 years.

Eldepryl also competitively inhibits the uptake of dopamine, norepinephrine and epinephrine (collectively referred to as catecholamines) into neurons. This unique ability among the MAO inhibitors prevents the “cheese effect,” a dangerous hypertensive reaction caused by neural uptake of tyramine from tyramine-containing foods like aged cheeses, certain wines, yeast, beans, chicken liver and herring. Eldepryl exhibits no significant cheese effect at therapeutic dosages, and only minimal effects at extremely high dosages.

Eldepryl is a drug that was discovered around 1964-65. It was originally developed as a “psychic energizer,” designed to integrate some amphetamine-like brain effects with antidepressant effects. Also known as L-deprenyl, (-)-deprenyl, and selegiline, eldepryl has been intensively researched over the past 36 years - many hundreds of research papers on eldepryl have been published. Eldepryl has been shown to protect nerve cells against a wide (and growing) number of neurotoxins. Eldepryl has also been shown to be a “neuroprotection/ neurorescue agent” when nerve cells are exposed to damaging or stressful conditions.

4. Dosage Form: The dose of eldepryl will be different for different patients. Your doctor will determine the proper dose of eldepryl for you. Follow your doctor's orders or the directions on the label.

For the treatment of Parkinson's disease, the usual dose of eldepryl is 5 mg two times a day, taken with breakfast and lunch. Some patients may need less than this.

5. Drug Interactions: Eldepryl can interact with other medications such as Demerol, and many depression medications. Be sure to talk to your doctor about any other medication you are taking before taking eldepryl. Although eldepryl is less likely than non-selective monoamine oxidase inhibitors to interact with tyramine in food, like other monoamine oxidase inhibitors it can produce life-threatening reactions when given with pethidine. Zornberg GL, et al. severe adverse interaction between pethidine and eldepryl.

6. Pregnancy: Eldepryl has not been studied in pregnant women. However, this medicine has not been shown to cause birth defects or other problems in animal studies.

7. Nursing Mothers: is not known whether eldepryl passes into the breast milk.

8. Dietary and Alcohol Considerations: Alcoholic beverages or alcohol-free or reduced-alcohol beer and wine. Foods that have a high tyramine content (most common in foods that are aged or fermented to increase their flavor), such as cheeses; fava or broad bean pods; yeast or meat extracts; smoked or pickled meat, poultry, or fish; fermented sausage (bologna, pepperoni, salami, summer sausage) or other fermented meat; sauerkraut; or any overripe fruit. If a list of these foods and beverages is not given to you, ask your health care professional to provide one.

9. Possible Side Effects: Common side effects are nausea and vomiting. The most frequent side effects also include chest pain (severe); enlarged pupils; fast or slow heartbeat; headache (severe); increased sensitivity of eyes to light; increased sweating (possibly with fever or cold, clammy skin); nausea and vomiting (severe); stiff or sore neck.

10. Storage: Keep this medication in the container it came in, tightly closed, and out of reach of children. Eldepryl should be stored at below 30°C (86°F) and away from excess heat and moisture (not in the bathroom). Heat or moisture may cause the medicine to break down. Keep away from light. Talk to your pharmacist about the proper disposal of your medication. Throw away any medication that is outdated or no longer needed. Be sure that any discarded medicine is out of the reach of children.

11. Package Size and Type: Tablets: 5 mg, 10 mg.

12. Where can I get more information on acarbose?
a) U.S. National Library of Medicine and National Institutes of Health
b) WebMD Corporation

Caution! Before starting to take this medicine, it is vital that you should consult your doctor! Do not use it on your own initiative, without medical advice.