Eldepryl (Selegiline) — Patient-Friendly Guide (UK)

Eldepryl is a medicine containing selegiline, a drug used mainly in Parkinson’s disease and, in some situations, for depression. This guide explains how it works, how it is taken, common safety considerations, and practical tips to help you use it confidently. It also covers interactions with food, alcohol and other medicines, and gives an overview of UK availability and regulatory context.

If you have questions about your specific situation, always follow the advice of your healthcare professional and read the patient information leaflet supplied with your medicine.

Basic product information

What is selegiline and how does it work?

Selegiline is a monoamine oxidase type B (MAO-B) inhibitor. MAO-B is an enzyme in the brain that helps break down certain chemical messengers, including dopamine.

By blocking MAO-B, selegiline helps reduce the breakdown of dopamine. This can improve or stabilise some symptoms of Parkinson’s disease, such as movement difficulties (bradykinesia), stiffness, and other motor symptoms.

At low doses, selegiline mainly targets MAO-B; at higher doses or with certain drug combinations, its selectivity may decrease. Because of this, selegiline has important interaction warnings, especially with antidepressants and other medicines that affect serotonin and other neurotransmitters.

Pharmacokinetics (how the body handles selegiline)

“Pharmacokinetics” describes how the body absorbs, distributes, metabolises and eliminates a medicine.

Absorption and onset

• Selegiline is taken by mouth and is absorbed through the gastrointestinal tract.
• The effects in Parkinson’s disease can build over time, while initial symptom changes may be noticed within days to weeks depending on the person and concurrent treatment.

Metabolism

• Selegiline is metabolised in the body to active and inactive breakdown products.
• This metabolism is influenced by the liver’s enzyme systems, which is one reason drug interactions can matter.

Elimination

• Metabolites are eliminated mainly via the kidneys (urine) and partly via the gut.
• The duration of action can be long enough for once-daily dosing in many cases, depending on the regimen.

Typical uses and indications in the UK

Selegiline (Eldepryl) is used primarily for:

Parkinson’s disease

• As treatment to improve motor symptoms in Parkinson’s disease.
• Often used as an adjunct to levodopa (or other Parkinson’s medicines) to help with symptom control and “on/off” fluctuations in some people.
• May be used in early disease in some management plans, depending on clinical factors.

Depression (selected situations)

• In certain cases, selegiline has been used as part of depression treatment. Choice of antidepressant depends on diagnosis, symptom pattern, and safety considerations.
• Because of interaction risks, antidepressant combinations must be handled carefully by a clinician.

Your healthcare professional will advise whether Eldepryl is appropriate for your diagnosis and current medicines.

How and when to take Eldepryl (timing)

Timing can be important for tolerability and to reduce side effects.

General timing guidance

• Many people take selegiline in the morning to reduce the chance of sleep disturbance.
• Follow your prescribed schedule exactly (including dose and time).

Missed dose

• If you miss a dose, take it when you remember if it is close to the scheduled time.
• If it is near the time of the next dose, skip the missed dose—do not double up.
• If you are unsure, seek advice from your pharmacist.

Food interactions

Because selegiline is an MAO-B inhibitor, dietary tyramine restrictions are generally less strict at typical low doses used for MAO-B selectivity. However, interaction risk can still increase with higher doses or with certain combinations.

Tyramine and “cheese/processed foods” concerns

• At typical doses for MAO-B inhibition, strict tyramine avoidance is often not required.
• You should still use caution with foods known to be very high in tyramine (for example, very aged, fermented or cured foods), especially if your healthcare professional has advised dietary caution.
• If you have a history of severe reactions to food or you are taking other interacting medicines, follow specific guidance given to you.

Practical food advice

• Keep your diet consistent and avoid making sudden large changes.
• Drink alcohol carefully (see below).
• Seek advice if you experience symptoms suggestive of a blood pressure reaction (e.g., severe headache, flushing, chest discomfort) after meals.

Alcohol and selegiline interactions

Alcohol may increase side effects such as dizziness, sleepiness and blood pressure effects. With medicines that affect the nervous system, combining alcohol can also make it harder to judge how you feel.

• If you drink alcohol, do so in moderation and monitor how you respond.
• Avoid binge drinking.
• If you notice increased dizziness, light-headedness, or mood changes, avoid alcohol and speak with your pharmacist or doctor.

In some cases, selegiline may be associated with blood pressure changes—alcohol can further affect circulation—so extra caution is sensible, especially early in treatment or after a dose change.

Medicine interactions (very important)

Selegiline can interact with other medicines, sometimes with serious consequences. Tell your healthcare professional and pharmacist about all medicines you take, including over-the-counter products and herbal supplements.

High-risk interaction groups

Antidepressants and serotonergic medicines

Combining selegiline with certain antidepressants or drugs that increase serotonin can raise the risk of serotonin syndrome, a potentially serious condition.

• Examples of medicines to consider include SSRIs and SNRIs, tricyclic antidepressants, some other antidepressants, and certain migraine medicines.
• Also caution with “natural” serotonergic supplements (for example, St John’s wort) because they can interact.

If you are switching between antidepressants and MAO inhibitors, clinicians often use “washout” periods to reduce risk. Do not start or stop antidepressants without medical guidance.

Other MAO inhibitors

• Using another MAO inhibitor alongside selegiline may significantly increase adverse effect risk.
• Always confirm compatibility with your pharmacist.

Sympathomimetic medicines (including some cough/cold products)

• Some decongestants (and cold/flu remedies) can affect blood pressure and heart rate.
• Check labels and ask a pharmacist if you are unsure.

Opioids and pain medicines

• Some opioid pain medicines can interact with MAO inhibitors and may increase the risk of dangerous reactions, including sedation, blood pressure changes or serotonin-related complications.
• Always inform your prescriber if you take any pain medicines, including tramadol.

Examples of supplements and “natural” products to mention

• St John’s wort (Hypericum perforatum)
• Other herbal mood products
• Dextromethorphan-containing cough remedies (in some cold medicines)

If you want, list your current medicines (including doses) and we can help you identify which categories to double-check with a pharmacist.

Dosing: common approaches and what to expect

The correct dose depends on the condition being treated, your age, other medicines you take, and your response.

General dosing principles

• Take selegiline exactly as advised—do not change the dose or stop suddenly without advice.
• Doses may differ for Parkinson’s disease versus depression.
• Your clinician may adjust dose based on side effects and symptom improvement.

Typical regimen (UK-typical clinical practice)

Many regimens use once-daily morning dosing or a schedule divided across the day depending on the formulation and condition.

• If you’ve been given a standard adult schedule, follow it closely and record your times.
• In people with liver problems, clinicians may choose extra caution.

Because Eldepryl is available in different tablet strengths and people may be started on different starting doses, please rely on your specific label and instructions.

Safety profile: side effects and when to seek help

Like all medicines, selegiline can cause side effects. Many people experience mild effects that improve as the body adjusts, but some effects require urgent attention.

Common side effects

• Headache
• Nausea or upset stomach
• Dizziness or light-headedness
• Sleep disturbance (especially if taken later in the day)
• Dry mouth or mild gastrointestinal changes

Less common but important effects

• Changes in blood pressure (sometimes causing dizziness on standing)
• Confusion or agitation (more likely with interacting medicines or dose changes)
• Rash or hypersensitivity reactions

Serious warning signs (seek urgent medical advice)

Get urgent medical help if you experience signs that could indicate serotonin syndrome, hypertensive reaction, or severe allergy.

• High fever, severe agitation, confusion
• Fast heart rate, sweating, tremor, muscle stiffness
• Severe headache with possible flushing or chest discomfort
• Fainting or severe shortness of breath
• Swelling of the face/lips or difficulty breathing (possible allergic reaction)

Who should be extra cautious?

• People taking multiple interacting medicines (especially antidepressants, cough/cold drugs, or certain pain medicines)
• People with a history of high blood pressure or cardiovascular disease, or those prone to dizziness
• People with liver impairment (your clinician may adjust dosing and monitoring)

Practical use tips

• Choose a consistent time: taking it at the same time each day can help prevent missed doses and reduce side effects.
• Take earlier in the day: if sleep disturbance happens, consider taking it in the morning (and discuss timing with your pharmacist).
• Check “cold & flu” labels: ask before using decongestants or combination remedies.
• Be cautious with new medicines: even short courses (antibiotics rarely, but cold/flu and antidepressants commonly) should be checked for interactions.
• Keep an updated list: write down your medicines and bring the list to appointments.
• Monitor symptoms: track tremor, mobility, sleep quality and any mood changes, especially during the first few weeks.

What to do if you feel unwell

If you develop concerning symptoms, especially after starting selegiline or after adding/removing another medicine, contact a healthcare professional promptly. When you call, mention you take selegiline (Eldepryl) and describe your symptoms and timing.

Alternative options to consider

Treatment depends on your condition, severity, age, and other health factors. Alternatives may include both medicine and non-medicine approaches.

For Parkinson’s disease

• Levodopa (often combined with a dopa decarboxylase inhibitor)
• Dopamine agonists
• Other MAO-B inhibitors (where appropriate)
• COMT inhibitors (for “on/off” fluctuations in some patients)
• Physiotherapy, exercise and supportive therapies

For depression

• SSRIs/SNRIs and other antidepressants (choice depends on the symptom profile and interaction risk)
• Psychological therapies such as CBT
• Lifestyle measures that support mood (sleep, activity, social support)

Your clinician can explain which alternatives best suit you, and whether switching would be safe given interaction risks.

UK market, legal and guidance context

In the UK, medicines are regulated under the Medicines and Healthcare products Regulatory Agency (MHRA) framework and provided according to national clinical guidance. Availability can vary by supplier, strength and formulation.

Selegiline-containing products are established in UK clinical practice. As with all centrally acting medicines, clinicians and pharmacists focus on:

• Correct indication and appropriate patient selection
• Safe prescribing and careful interaction checks
• Monitoring for side effects and changing symptoms over time
• Patient education to prevent unsafe combinations (particularly antidepressants and serotonergic agents)

Recent guidance and safety emphasis (general)

While guidance may evolve, the most consistent safety themes across recent years include:

• Strengthening awareness of serotonin syndrome risk when MAO-related medicines are combined with serotonergic antidepressants and other agents.
• Encouraging clinicians and pharmacists to check interactions with over-the-counter cold remedies and herbal supplements.
• Emphasising correct timing to reduce sleep disturbance.

Your pharmacy team can help check interactions with any planned changes to your treatment.

Delivery, availability and what to expect when ordering (UK)

Availability may vary depending on stock levels and product presentation. Eldepryl (selegiline) may be supplied in different tablet strengths and packaging formats.

Typical ordering and dispatch

• Orders are usually processed quickly when items are in stock.
• If stock is limited, you may be offered an alternative strength (if appropriate) or informed about delivery timing.
• Always check that the medicine strength and form match the instructions you expect.

Packaging and storage

• Keep tablets in their original packaging.
• Store at room temperature away from excess heat and moisture.
• Keep out of sight and reach of children.

If you have an urgent need for your medicine, contact the pharmacy support team so they can advise on current dispatch times and options.

FAQ: Frequently asked questions

1) What is Eldepryl used for?

Eldepryl contains selegiline. It is used mainly for Parkinson’s disease to help improve or stabilise symptoms. It may also be used in selected cases of depression depending on clinical assessment and interaction risk.

2) How long does it take to work?

Some people notice effects within days to weeks, but for Parkinson’s symptoms it may take longer to judge full benefit. Improvement can also depend on other medicines you take alongside selegiline. If you are adjusting dose, allow time for stabilisation and discuss progress with your healthcare professional.

3) Can I take it with food?

Many people take selegiline with or without food. However, specific advice may depend on your formulation and personal tolerability. If you find it upsets your stomach, taking it with food may help—ask your pharmacist if you’re unsure.

4) Do I need to avoid tyramine foods like cheese?

At typical MAO-B inhibitor doses, strict tyramine avoidance may not be necessary. Still, use caution with very high tyramine foods (especially aged, cured or fermented items) and follow any dietary instructions given to you by your clinician or pharmacist.

5) Is alcohol safe with selegiline?

Alcohol may increase side effects like dizziness and can affect blood pressure and sleep. If you drink, do so in moderation and monitor how you feel. If you experience significant dizziness, agitation or sleep problems, avoid alcohol and ask a pharmacist for advice.

6) What medicines should I avoid?

The biggest safety concerns are with medicines that affect serotonin or other neurotransmitters (to reduce serotonin syndrome risk), other MAO inhibitors, and certain decongestants or cough/cold products. Always check with a pharmacist before starting or stopping any medicine, including over-the-counter and herbal products.

7) What side effects are common?

Common side effects may include headache, nausea, dizziness and sleep disturbance (particularly if taken later in the day). If side effects are persistent or troublesome, discuss them with your healthcare professional.

8) When should I seek urgent help?

Seek urgent medical advice for severe symptoms such as high fever, confusion, severe agitation, muscle stiffness, fainting, or signs of an allergic reaction (swelling, difficulty breathing). Also seek help if you get a severe headache with other concerning symptoms after meals or medicine changes.

9) Can I stop Eldepryl suddenly?

Do not stop without advice. If you want to stop, speak to your healthcare professional, as they can advise on a safe plan and help manage your symptoms.

10) Are there alternatives if it doesn’t suit me?

Yes. For Parkinson’s disease, other medicine options (such as levodopa-based treatment, dopamine agonists, COMT inhibitors or other MAO-B inhibitors) may be considered. For depression, there are multiple antidepressant and therapy options. Your clinician can recommend the safest alternative for your circumstances.

Summary

Eldepryl (selegiline) is a MAO-B inhibitor most commonly used in Parkinson’s disease to help improve dopamine-related symptoms. It works by reducing dopamine breakdown, but it requires careful attention to drug interactions, including many antidepressants and some over-the-counter cold remedies. Taking it at the right time (often in the morning) and keeping your medication list up to date with your pharmacy team can help you use it safely and effectively.