Eldepryl Capsules and Zolmitriptan Nasal Spray

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Although an interaction has not been reported, some concern exists that using selegiline together with medications like ZOLMitriptan may increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Coadministration of selegiline with 5-HT1 receptor agonists may be associated with a theoretical risk of serotonin syndrome. The proposed mechanism involves an additive pharmacodynamic effect resulting from inhibition of serotonin metabolism and stimulation of 5-HT1A receptors. However, there have been no published reports of an interaction in the medical literature, and the risk appears to be quite low based on available evidence and known pharmacology of these agents. As a class, 5-HT1 receptor agonists have rarely been associated with development of serotonin syndrome, and the reports that have been published generally describe concomitant use with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs)--agents that are well known causes of serotonin syndrome. The paucity of reported cases is consistent with the fact that 5-HT1 receptor agonists have the greatest affinity for 5-HT1D and 5-HT1B receptors, whereas serotonin syndrome is thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. The 5-HT1 agonists that are currently marketed have demonstrated only modest affinity for 5-HT1A receptors and little to no affinity for 5-HT2A receptors. With respect to selegiline, it is considered a monoamine oxidase (MAO)-B inhibitor and does not affect the pharmacokinetics of 5-HT1 receptor agonists that are metabolized by MAO-A such as rizatripan, sumatriptan, and zolmitriptan. It is also not expected to cause serotonin syndrome when used at dosages recommended for the treatment of Parkinson's disease. However, MAO-B selectivity may be reduced with increasing dosages and some antidepressant dosages, which could theoretically increase the risk of serotonin syndrome when combined with other serotonergic agents.

MANAGEMENT: Caution is advisable when 5-HT1 receptor agonists are used with selegiline, particularly at dosages higher than that recommended for the treatment of Parkinson's disease. Patients should be monitored for symptoms of the serotonin syndrome, which may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. If serotonin syndrome develops or is suspected during the course of therapy, all serotonergic agents should be discontinued immediately and supportive care rendered as necessary. Moderately ill patients may also benefit from the administration of a serotonin antagonist (e.g., cyproheptadine, chlorpromazine). Severe cases should be managed under consultation with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical ventilation in addition to the other measures.

Eldepryl Capsules

Generic Name: selegiline

Brand name: Eldepryl, Zelapar, Emsam

Synonyms: Eldepryl

What is Eldepryl Capsules?

Zolmitriptan Nasal Spray

Generic Name: zolmitriptan

Brand name: Zomig, Zomig-ZMT

Synonyms: Zolmitriptan, ZOLMitriptan

What is Zolmitriptan Nasal Spray?