188.8.131.52 Monoamine-oxidase-B (MAOB) inhibitors
|1st choice||Rasagiline tablets 1mg||Dose:|
|2nd choice||Selegiline tablets 5mg, 10mg; oral lyophilisate 1.25mg|
Oral lyophilisate tablets:
- MAOB inhibitors can be used as monotherapy in early Parkinson’s disease to improve motor symptoms and delay the need for levodopa.
- MAOB inhibitors may be used as an adjunct to levoldopa in later Parkinson’s disease for ‘end-of-dose’ fluctuations.
- When combined with levodopa, MAOB inhibitors should be avoided or used with great caution in postural hypotension.
- Drug interaction between MAOB inhibitors and antidepressants (risk of serotonin syndrome):
- SSRIs, venlafaxine or duloxetine should not be used by people taking selegiline or rasagiline
- tricyclic antidepressants should not be used without specialist advice by people taking selegiline or rasagiline
- people taking selegiline or rasagiline may cautiously use trazodone or mirtazapine (off-label use for selegiline)