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The following information outlines critical safety warnings and precautions for the use of selegiline. It is essential to review these details and discuss any concerns with your healthcare provider.

• High Blood Pressure: Selegiline may increase or exacerbate high blood pressure, particularly if doses exceed 10 mg per day for tablets or capsules, or 2.5 mg per day for the orally disintegrating tablet (ODT). Adhere strictly to the prescribed dosage. Avoid foods high in tyramine to reduce the risk.

• Serotonin Syndrome: This rare but severe condition can occur when selegiline is used with other serotonin-enhancing medications, like antidepressants. Symptoms include a rapid heartbeat, sweating, muscle rigidity, fever, and confusion. Immediate medical attention is necessary if these symptoms manifest. Inform your prescriber about all current medications to ensure safe use.

• Excessive Sleepiness: Selegiline may cause sudden sleep episodes, particularly if taken with other drowsiness-inducing drugs such as benzodiazepines or muscle relaxants. The risk is increased in individuals with a history of sleep issues or those aged 65 and older.

• Low Blood Pressure and Fall Risk: Selegiline can lead to decreased blood pressure, causing dizziness or instability, especially when standing. Stand up slowly and support yourself to prevent falls. Consult your prescriber if you experience fainting or falls.

• Uncontrolled Body Movements: Selegiline may induce or worsen involuntary movements. Notify your prescriber if such symptoms occur, as dosage adjustments might be necessary.

• Hallucinations and Behavioral Changes: Users may experience hallucinations or mood alterations. This medication is generally not recommended for individuals with a history of mental health disorders. Report any such symptoms to your prescriber immediately.

• Intense Urges: Some individuals may develop compulsive behaviors, such as gambling or excessive eating. Notify your prescriber if you notice these changes so that medication adjustments can be made.

• Phenylketonuria Caution: If you have phenylketonuria (PKU), inform your healthcare team, as Zelapar ODTs contain phenylalanine.

Contraindications: Selegiline should not be used if you are currently taking, have recently taken, or plan to take within the next 14 days, any monoamine oxidase inhibitors (MAOIs), linezolid, opioids, St. John's wort, cyclobenzaprine, or medications containing dextromethorphan. Consult with your healthcare provider if any of these conditions apply to you.

When taking this medication, some people may experience common side effects that are often mild. These include nausea, dizziness, stomach pain, dry mouth, headache, and trouble sleeping. The symptoms of nausea and dizziness are more common, affecting about 20% and 14% of users respectively. If these effects persist or worsen, it is advisable to consult your healthcare provider.

Other side effects that have been reported include general body pain, confusion, hallucinations, runny nose, involuntary movements (dyskinesia), back pain, indigestion, and mouth irritation such as sores or pain when swallowing. Though these are less common, they can still be bothersome, and you should inform your healthcare provider if they occur.

Serious side effects, though rare, require immediate medical attention. These include severe headaches, involuntary movements, vivid dreams, and significant trouble sleeping. Additionally, there is a risk of a hypertensive crisis, marked by severe headaches, chest pain, and vision changes, which can be life-threatening. Another rare but serious condition is serotonin syndrome, with symptoms such as hallucinations, rapid heartbeat, and severe dizziness. If any of these symptoms develop, seek urgent medical care.

In rare instances, severe allergic reactions may occur, characterized by rash, swelling, severe dizziness, or trouble breathing. Immediate medical attention is necessary if these symptoms arise. Always inform your healthcare provider of all medications you are taking to avoid adverse interactions.

Selegiline can interact with various medications and supplements, and it is essential to inform your doctor and pharmacist about all drugs and supplements you are taking, including prescription, over-the-counter, vitamins, and herbal products. The interactions listed here are not exhaustive, so always consult your healthcare provider for advice.

Certain medications should not be used with selegiline, as these combinations can pose serious risks. These include antidepressants like amitriptyline and bupropion, MAO inhibitors such as isocarboxazid and phenelzine, and stimulants like amphetamine and methylphenidate. Taking these drugs with selegiline may increase the risk of serotonin syndrome or other severe side effects.

Some medications, while usually not recommended with selegiline, may be necessary in specific cases. If prescribed together, your doctor might adjust the dosage or frequency of these medications. Examples include opioid pain relievers like fentanyl and methadone, and certain migraine treatments like sumatriptan.

Other drugs may increase the risk of side effects when used with selegiline, but the combined treatment may still be beneficial. In such cases, your doctor will carefully monitor and adjust your treatment as needed.

To prevent serious high blood pressure reactions, do not increase your selegiline dose without consulting your doctor, and adhere to any dietary restrictions, particularly those related to tyramine-rich foods, as advised by your healthcare provider. If you experience symptoms like a very fast or slow heartbeat, severe headache, or sudden vision changes, seek medical attention immediately.

Additionally, selegiline may interfere with certain lab tests, so ensure your healthcare providers are aware you are taking this medication.