Zelapar tablets contain the active ingredient selegiline, which is a type of medicine called a selective monoamine-oxidase-B inhibitor. (NB. Selegiline is also available without a brand name, ie as the generic medicine.) Selegiline increases the levels of a substance in the brain called dopamine, and is used in the treatment of Parkinson's disease.
Dopamine is a substance known as a neurotransmitter. Neurotransmitters are present in the brain and nervous system and are involved in transmitting messages between nerves. These messages allow the normal functioning of the body. The neurotransmitter dopamine is known to be reduced or absent in the brains of people with Parkinson's disease, and this is thought to be the cause of the disease symptoms. The mainstay of treating Parkinson's disease is to replace dopamine in the brain.
Natural dopamine released from nerve cells in the brain is normally broken down by an enzyme called monoamine-oxidase-B (MAO-B). Selegiline works by blocking the action of this enzyme, which prevents the monoamine-oxidase-B from breaking down the dopamine. This results in an increased amount of active dopamine in the brain, and this reduces the symptoms of Parkinson's disease.
Selegiline is usually used in combination with a medicine called levodopa to treat advanced Parkinson's disease. Levodopa is converted into dopamine in the brain and therefore works by directly replacing the lost dopamine. Unfortunately, levodopa treatment tends to become less effective over time and patients tend to experience 'end-of-dose' deterioration, where the effect of each dose of levodopa becomes progressively shorter. Selegiline can be used to prolong the effect of levodopa, because it stops the dopamine that is formed from the levodopa from being broken down in the brain. This extends the action of levodopa thereby reducing the 'end-of-dose' side effects.
Selegiline can also be used on its own earlier in the progression of Parkinson's disease, when it can delay the need for levodopa treatment.
Selegiline should not be used in combination with levodopa in any of the following conditions:
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.
This medicine should not be taken with any of the medicines listed below, because the combination may carry a risk of serious side effects:
This medicine will enhance the effect of levodopa treatment. If you are taking levodopa when you start this medicine, your doctor will need to decrease your levodopa dose in order to optimise the beneficial effects, but avoid enhanced side effects. Once your optimal dose of levodopa is reached, you should experience fewer side effects from the combination than you were from levodopa alone.
The manufacturer recommends that medicines containing oestrogens or progestogens (eg contraceptives and HRT), should be avoided in people taking selegiline, because these hormones may increase the blood level of selegiline and thus increase the risk of its side effects.
The manufacturer recommends that nasal decongestants such as ephedrine and pseudoephedrine should be avoided by people taking this medicine, because the combination may risk causing a hypertensive crisis.
The manufacturer also recommends that the following medicines are avoided by people taking selegiline:
Selegiline tablets are also available without a brand name, ie as the generic medicine.