If a dose of the selegiline patch is missed, the general consensus is to apply it as soon as possible unless it is close to the time for the next scheduled dose. In that case, skip the missed dose and continue with the regular dosing schedule. Importantly, never apply extra patches to compensate for a missed dose, as this could lead to overdose or adverse effects. If a patch falls off, it should be reapplied or replaced immediately, but the same principle of avoiding extra patches applies.
Key Points Explained:
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Immediate Application if Remembered Early
- If you realize you missed a dose and it is not yet close to the next scheduled application time, remove the old patch (if still on) and apply a new one immediately.
- This ensures continuous medication delivery without significant gaps in treatment.
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Skipping the Missed Dose if Close to Next Application
- If the missed dose is noticed near the time of the next scheduled patch change (e.g., within a few hours), skip the missed dose entirely.
- Applying a new patch too soon could lead to excessive drug levels in the body, increasing the risk of side effects.
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Never Use Extra Patches to Compensate
- Doubling up on patches to make up for a missed dose is dangerous and can result in an overdose.
- Selegiline, a monoamine oxidase inhibitor (MAOI), has a narrow therapeutic window, and excessive doses can cause severe hypertension or serotonin syndrome.
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Handling a Fallen-Off Patch
- If the patch detaches prematurely, try to reapply it if still adhesive.
- If reapplication isn’t possible, apply a new patch to a different skin area but avoid using an additional patch beyond the prescribed amount.
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Resuming the Regular Schedule
- After addressing the missed dose (either by immediate application or skipping), continue with the next patch change at the originally planned time.
- This maintains steady-state drug levels and minimizes fluctuations in efficacy.
By following these steps, patients can safely manage missed doses while minimizing risks associated with improper dosing. Always consult a healthcare provider if unsure about the best course of action.
Summary Table:
| Scenario | Action |
|---|---|
| Missed dose remembered early | Apply new patch immediately, remove old one if still on. |
| Close to next scheduled dose | Skip missed dose, continue regular schedule. |
| Patch falls off | Reapply if possible or replace with a new one (no extra patches). |
| Never compensate with extra patches | Avoid doubling up to prevent overdose risks. |
| Resume regular schedule | Continue next dose at the planned time. |
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