Selegiline transdermal patch, a monoamine oxidase inhibitor (MAOI) used for depression, has significant drug interactions due to its mechanism of action. Key interactions include other antidepressants (especially SSRIs like fluoxetine, requiring a 5-week washout), stimulants, cough/cold medicines, and thyroid medications (may need dose adjustments). It can also interfere with lab tests. Common side effects are localized skin reactions and systemic effects like insomnia or GI upset. Always disclose all medications to healthcare providers to avoid serious interactions like serotonin syndrome or hypertensive crisis.
Key Points Explained:
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Antidepressant Interactions
- SSRIs/SNRIs: Concurrent use with Selegiline Transdermal Patch risks serotonin syndrome (e.g., fluoxetine requires a 5-week gap).
- Other MAOIs/Tricyclics: Contraindicated due to amplified MAOI effects.
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Stimulants and Over-the-Counter (OTC) Medications
- Decongestants/Cough Syrups: Phenylephrine or dextromethorphan can cause hypertensive crises.
- Diet Pills/Stimulants: Amphetamines or caffeine may exacerbate cardiovascular side effects.
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Thyroid Medications
- Levothyroxine: Selegiline may necessitate higher thyroid hormone doses; monitor TSH levels closely.
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Lab Test Interference
- Thyroid/Coagulation Tests: Alters results for PT, lipids (HDL/LDL), and hormone assays.
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Other Notable Interactions
- Nitroglycerin: Risk of severe hypotension (though more relevant to oral MAOIs).
- Herbal Supplements: St. John’s wort or yohimbine may increase serotonin or blood pressure unpredictably.
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Side Effects Requiring Monitoring
- Local: Patch-site redness/itching (rotate application sites).
- Systemic: Insomnia, dry mouth, or GI distress; report persistent symptoms.
Practical Consideration: Always review a patient’s full medication list—including OTCs and supplements—before prescribing to mitigate risks. For purchasers, ensure patches are stored properly (room temperature) to maintain efficacy.
This patch’s interactions underscore the importance of interdisciplinary communication in healthcare, where even transdermal delivery requires vigilance akin to systemic drugs.
Summary Table:
| Interaction Category | Examples | Potential Risks |
|---|---|---|
| Antidepressants (SSRIs/SNRIs) | Fluoxetine, sertraline | Serotonin syndrome (5-week washout needed) |
| OTC Medications | Decongestants, cough syrups | Hypertensive crisis |
| Thyroid Medications | Levothyroxine | Altered TSH levels (dose adjustment needed) |
| Lab Tests | PT, lipid panels, hormone assays | False results |
| Herbal Supplements | St. John’s wort, yohimbine | Unpredictable BP/serotonin effects |
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