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Is Zelapar Right for
Your Patients?
Wearing off can begin early in therapy,
with data demonstrating that more than 25% of patients experienced
dyskinesias after 13 to 24 months of levodopa/carbidopa therapy.
By years 4 to 6, this number increased to nearly 40%.
One approach to clinical management of wearing off has been to increase levodopa/carbidopa
dose or frequency, however, increasing the levodopa/carbidopa dose can increase
complications. Results of a 42-week study published in the New England Journal
of Medicine
in December, 2004 demonstrated that OFF time and dyskinesias increased at significant
(600/150 mg/day) levodopa/carbidopa doses.
Adding Zelapar® (selegiline HCl) as an adjunctive therapy
boosts the action of levodopa/carbidopa. Zelapar reduces OFF time by 2.2 hours per day.
Zelapar is well-tolerated
The most commonly observed adverse effects
include nausea, dizziness, pain, headache, insomnia, rhinitis,
dyskinesia, skin disorders, stomatitis, back pain and dyspepsia.
When combined with levodopa/carbidopa, selegiline may be
associated with dopaminergic effects that can usually be
managed by decreasing the levodopa dose.
Selegiline produces 3 major metabolites, including amphetamine and methamphetamine. The effects of these metabolites are not known; however, they have been associated with properties such as neurotoxicity and cardiovascular toxicity. Importantly, the unique delivery system of Zelapar has been shown to produce an 80% – 90% reduction in plasma levels of amphetamine-like metabolites compared to conventional selegiline oral tablets (10 mg). |
