Eldepryl
In brief
- Eldepryl (selegiline) is a prescriptionâonly medicine (POM) in the UK.
- Eldepryl (selegiline) is used mainly as an adjunct treatment for Parkinsonâs disease; it is a selective monoamine oxidase B (MAOâB) inhibitor that reduces dopamine breakdown and thereby increases central dopaminergic activity.
- Usual adult dosage is 5â10 mg daily (commonly 5 mg twice daily) for tablets; orally disintegrating tablets (Zelapar) are usually 1.25â2.5 mg once daily; doses may be adjusted when used with levodopa/carbidopa.
- Forms of administration include oral tablets and orally disintegrating tablets, both taken by mouth.
- Pharmacological effects begin within hours, but noticeable symptomatic improvement in Parkinsonâs symptoms typically occurs over days to weeks.
- MAOâB inhibition generally lasts about 24 hours and clinical effects persist with onceâ or twiceâdaily dosing (irreversible inhibition prolongs effect beyond plasma halfâlife).
- Avoid or limit alcohol â alcohol can worsen side effects such as dizziness and hypotension and, together with tyramineâcontaining foods or drinks, may increase the risk of hypertensive reactions; follow dietary cautions for MAOIs.
- The most common side effect is nausea; other frequent effects include dry mouth, dizziness, insomnia, headache, abdominal pain and increased sweating.
- Would you like to try Eldepryl without a prescription?
Legal status and availability in the UK
In our online pharmacy, Eldepryl is available without a prescription, with discreet delivery to the United Kingdom in 9â21 days.
Basic Eldepryl information
- INN (international nonproprietary name): Selegiline.
- Brand names available in the United Kingdom: Eldepryl tablets (5 mg, 10 mg) in blister packs of 28 or 100.
- ATC code: N04BD01.
- Forms and dosages: tablets 5 mg and 10 mg (blisters 28, 100); orally disintegrating tablet 1.25 mg (Zelapar).
- Manufacturers in the United Kingdom: Sovereign Medical.
- Registration status in the United Kingdom: Prescription only; licensed by the MHRA.
- OTC / Rx classification: Prescription only (Rx) in the United Kingdom.
Clinical effectiveness in the United Kingdom
How effective is selegiline in NHS practice for people with Parkinsonâs?
Selegiline produces modest improvements in motor symptoms and can delay escalation of levodopa dose in early Parkinsonâs disease.
Effect sizes in randomised trials tend to be smaller than for some newer agents.
Vigilance is needed for psychiatric effects and orthostatic hypotension, especially in older adults with polypharmacy.
Pharmacist counselling commonly includes practical tips such as taking the tablet with food if nausea occurs and avoiding large tyramineârich meals.
Indications and expanded uses
What is selegiline licensed for, and where is it used offâlabel?
Selegiline is licensed in the UK as an antiâParkinson agent (ATC code N04BD01).
Oral Eldepryl tablets are used for Parkinsonâs disease in UK practice.
In NHS settings clinicians sometimes consider cautious offâlabel uses such as sleepâwake regulation, but consensus remains cautious and specialist input is commonly sought.
Private neurology clinics may trial lowâdose orally disintegrating tablets such as Zelapar 1.25 mg for patients with swallowing difficulties.
GPs and pharmacists routinely explain prescriptionâonly status and the need to update medication lists before starting new drugs because of interaction risks.
- MHRAâapproved uses: Adjunct treatment in Parkinsonâs disease (tablet formulations Eldepryl 5 mg, 10 mg).
- Offâlabel uses: occasional specialist use for sleepâwake symptoms.
Prescriber checklist when considering expanded use:
- Confirm Parkinsonâs diagnosis and current levodopa dose.
- Review all prescription and OTC medicines for serotonergic or MAOI interactions.
- Consider ODT form for dysphagia and start at lower dose in older patients.
- Arrange early followâup and BP monitoring after initiation.
Composition and brand landscape
Which brands and formulations of selegiline will patients see in the UK?
The INN is selegiline and the principal UK brand is Eldepryl supplied as tablets in 5 mg and 10 mg strengths in blister packs of 28 or 100.
Zelapar orally disintegrating tablets are another selegiline formulation, and generic selegiline tablets are also available.
| Form | Strengths | Typical packaging |
|---|---|---|
| Tablet | 5 mg, 10 mg | Blisters 28, 100 |
| Orally disintegrating tablet | 1.25 mg (Zelapar) | Blisters |
- UK manufacturer/supplier example: Sovereign Medical.
Patients may see different brands and are advised to check the label matches their GP directions.
Contraindications and special precautions
Who should not take selegiline and what precautions matter most?
Absolute contraindications recorded in the summary of product characteristics include hypersensitivity to selegiline, concomitant use with other MAOIs, certain opioids such as pethidine, serotonergic agents and phaeochromocytoma.
UK pharmacovigilance highlights the risk of hypertensive crisis and serotonin syndrome where contraindications or interacting medicines are overlooked.
Elderly patients and those with cardiovascular comorbidity need particular caution given increased sensitivity to orthostatic hypotension.
| Contraindication type | Examples |
|---|---|
| Absolute | Hypersensitivity; concurrent MAOIs; pethidine and some opioids; serotonergic drugs; phaeochromocytoma. |
| Relative | History of peptic ulcer disease; severe cardiovascular disease; psychosis or mania; heavy tyramine intake. |
Pharmacist counselling points:
- Screen prescription and OTC lists for SSRIs, SNRIs, tramadol and herbal serotonergic agents.
- Advise on avoiding large tyramineârich meals to reduce hypertensive risk.
- Caution about dizziness and advise against driving until stable.
- Avoid heavy alcohol use and seek specialist advice in pregnancy and breastfeeding.
Dosage guidelines
How is selegiline dosed in UK practice and what adjustments are needed?
Standard Parkinsonâs dosing for tablets is 5â10 mg daily, commonly given as 5 mg twice daily.
Orally disintegrating forms such as Zelapar are dosed at 1.25â2.5 mg once daily.
UK formularies and product labelling recommend starting low and careful titration in older patients and those with hepatic impairment.
| Patient group | Typical dose | Notes |
|---|---|---|
| Adults (Parkinsonâs) | 5â10 mg/day (often 5 mg twice daily) | Adjunct to levodopa as required. |
| ODT (dysphagia) | 1.25â2.5 mg once daily | Useful when swallowing tablets is difficult. |
| Elderly / hepatic impairment | Start at lower end of range | Use cautious titration and monitor closely. |
Missed dose advice: take as soon as remembered unless close to the next dose and do not double doses.
Overdose warning: overdose may cause severe hypertension, agitation, convulsions or hallucinations and requires immediate medical attention.
Interactions overview
Which medicines and foods interact with selegiline and how are they managed?
Major interactions listed by MHRA and in SPCs include other MAOIs, certain opioids (for example pethidine), potent serotonergic drugs and tyramineârich foods which can precipitate hypertensive crises or serotonin syndrome.
Antidepressant interactions are a particular concern, emphasising the need for careful review on initiation.
| Highârisk drug class | Recommended management |
|---|---|
| Other MAOIs | Contraindicated; do not coâprescribe. |
| Opioids (e.g. pethidine) | Contraindicated; avoid or seek specialist advice. |
| SSRIs, SNRIs, tramadol | Avoid combination where possible; consult psychiatry/neurology and monitor for serotonin syndrome. |
| Sympathomimetics / decongestants | Restrict use; monitor BP and avoid high doses. |
Foods to avoid: large amounts of aged cheese, cured meats, yeast extracts and other highâtyramine items.
Practical point: UK prescribers and pharmacists commonly rely on electronic prescribing flags and community pharmacy screening to prevent dangerous combinations.
Comparable medicines and prescribing preferences
What are the alternatives to selegiline and how do clinicians choose between them?
Rasagiline and safinamide are commonly positioned alongside selegiline as MAOâB inhibitors for Parkinsonâs disease.
Rasagiline is often preferred for onceâdaily convenience and a straightforward dosing regimen.
Safinamide offers reversible MAOâB inhibition and has a slightly different adverseâeffect profile that can be useful for some patients with wearingâoff.
COMT inhibitors such as entacapone are used for wearingâoff but work by a different mechanism and are often combined with levodopa rather than replacing MAOâB inhibitors.
| Drug | Efficacy | Dosing | Main cautions |
|---|---|---|---|
| Selegiline | Modest symptomatic benefit; levodopaâsparing effects | 5â10 mg/day; ODT 1.25â2.5 mg once daily | MAOI interactions; tyramine sensitivity; orthostatic hypotension |
| Rasagiline | Comparable modest benefit | Once daily | Similar MAOI interaction cautions; often easier dosing |
| Safinamide | Adjunct for wearingâoff with reversible MAOâB action | Once daily | Monitor for adverse effects; different interaction profile |
Choice on the NHS is influenced by symptom profile, comorbidity, polypharmacy and local formulary or ICS guidance.
Patients often prefer onceâdaily or ODT forms for ease of use and when swallowing is difficult.
Frequently asked questions
Can I drive on selegiline?
Follow MHRA and clinical guidance: do not drive until you know how selegiline affects you.
Be cautious if you experience dizziness or orthostatic hypotension and avoid driving until symptoms stabilise.
What foods should I avoid?
Avoid large amounts of tyramineârich foods such as aged cheeses, cured meats and yeast extracts.
Pharmacists will provide tailored diet counselling when dispensing Eldepryl tablets.
What if I miss a dose?
Take the missed dose as soon as you remember unless it is nearly time for the next dose and do not double up.
Seek urgent medical attention for signs of overdose such as severe hypertension or agitation.
Can I take my antidepressant?
Do not combine selegiline with antidepressants without specialist advice due to the risk of serotonin syndrome.
Consult your GP or neurologist before starting or stopping any antidepressant when on an MAOâB inhibitor.
Guidelines for proper use
What steps should pharmacists and prescribers follow to ensure safe treatment with selegiline?
Preâprescription checks:
- Review full medication list including OTC and herbal products.
- Assess cardiovascular history and psychiatric history.
- Confirm indication and discuss dietary restrictions with the patient.
Initiation advice:
- Start at the lower end of the dosing range and titrate slowly in older adults.
- Advise on missedâdose rules and signs of serotonin syndrome or hypertensive crisis.
- Provide written instructions and recommend using the NHS App or patient portal for reminders.
Followâup schedule:
- BP check and mental status review after initiation and at routine intervals.
- Medication review when other drugs are prescribed, especially antidepressants or opioids.
- Report suspected adverse reactions via the MHRA Yellow Card scheme.
| Storage | Overdose actions |
|---|---|
| Store in original packaging at room temperature (below 25°C), away from moisture and light. | Seek immediate medical attention; monitor BP and treat hypertension and neuropsychiatric symptoms urgently. |
Always consult the product SPC and local formulary when prescribing or dispensing Eldepryl and involve carers in counselling where appropriate.
Delivery across the United Kingdom
| City | Region | Delivery Time |
|---|---|---|
| London | England | 9â21 days |
| Birmingham | England | 9â21 days |
| Manchester | England | 9â21 days |
| Glasgow | Scotland | 9â21 days |
| Leeds | England | 9â21 days |
| Liverpool | England | 9â21 days |
| Bristol | England | 9â21 days |
| Edinburgh | Scotland | 9â21 days |
| Sheffield | England | 9â21 days |
| Leicester | England | 9â21 days |
| Nottingham | England | 9â21 days |
| Newcastle | England | 9â21 days |
| Cardiff | Wales | 9â21 days |
| Belfast | Northern Ireland | 9â21 days |
| Coventry | England | 9â21 days |
