Zelapar Warnings and Precautions

Because Zelapar can cause dangerous and even life-threatening problems, talk to your healthcare provider about any potential risks before starting treatment with Zelapar. Warnings and precautions for this medication can include potentially lethal drug interactions, so make sure your healthcare provider is aware of all other medicines you are taking. Also, you may not be able to take Zelapar if you have certain health conditions.

Zelapar: What Should I Tell My Healthcare Provider?

Talk with your healthcare provider prior to taking Zelapar® (orally disintegrating selegiline) if you have:
 
  • Phenylketonuria
  • Liver disease, such as liver failure, hepatitis, or cirrhosis
  • Kidney disease, such as kidney failure (renal failure)
  • Any allergies, including allergies to foods, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Make sure to tell your healthcare provider about any other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Specific Zelapar Warnings and Precautions

Warnings and precautions to be aware of prior to taking Zelapar include the following:
 
  • Zelapar has several potentially lethal drug interactions. In order to take it safely, you must commit to avoiding many medications, including several non-prescription medications. Always check with your healthcare provider before taking any medication (see Zelapar Drug Interactions).
     
  • The medication should not be taken at doses higher than 2.5 mg per day. Although no special diet is required for normal Zelapar dosages (1.25 mg to 2.5 mg per day), higher doses interact dangerously with many foods.
     
  • Zelapar can cause hypertensive crisis, which is a life-threatening increase in blood pressure. Tell your healthcare provider right away if you have symptoms of a hypertensive crisis, such as:
 
    • Headaches
    • Feelings of a rapidly or forcefully beating heart (palpitations)
    • A sore or stiff neck
    • Nausea or vomiting
    • Sweating, with a high fever (or sometimes with cold, clammy skin)
    • Sensitivity to light
    • A rapid heart rate (tachycardia) or low heart rate (bradycardia)
    • Chest pain or throat tightness
    • Dilated (wide open) pupils.
 
  • The liver and kidneys help remove Zelapar from the body. The drug has not been adequately studied in people with liver or kidney disease.
     
  • Taking Zelapar with levodopa medications (such as Sinemet®, Sinemet® CR, Parcopa®, or Stalevo®) can increase the risk of involuntary muscle movements called dyskinesia. Although not typically dangerous, dyskinesia can be quite disturbing and intolerable. If you develop a severe dyskinesia while taking Zelapar and levodopa, your healthcare provider may need to decrease your levodopa dosage.
     
  • Zelapar can cause low blood pressure (hypotension). Let your healthcare provider know if you develop signs of low blood pressure, such as dizziness, fainting, or lightheadedness.
     
  • Zelapar tablets contain phenylalanine, an amino acid. This is important for people who have phenylketonuria, who must limit their intake of phenylalanine.
     
  • Zelapar tablets can cause mouth irritation and sores.
     
  • The medication can cause hallucinations (seeing, feeling, tasting, smelling, or hearing things that aren't there). Let your healthcare provider know if you think you may be hallucinating while taking Zelapar.
     
  • Studies have suggested that people who take Parkinson's medications (including Zelapar) may have a higher risk of malignant melanoma (a type of skin cancer). However, it is not clear if this truly is a problem, as this may simply reflect the fact that people with Parkinson's have a higher risk of melanoma than normal.

 

  • There have been a few reports of unusual compulsive behaviors, such as gambling, binge eating, or hypersexuality, in people taking Zelapar or other Parkinson's disease medications. Let your healthcare provider know if you develop any such behaviors while taking the drug. Also, let your friends, family, or caretakers know about this potential side effect, as they may be better able to identify the problem. 

 

  • Zelapar is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Zelapar and Pregnancy).
     
  • It is not known if Zelapar passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Zelapar and Breastfeeding).
     
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