Zelapar prevents the breakdown of a chemical in your brain called dopamine. Low levels of dopamine are associated with Parkinson's disease.

Zelapar is used along with carbidopa and levodopa to treat symptoms of Parkinson's disease. It works by helping levodopa to work against Parkinson disease for a longer period of time.

Zelapar may also be used for purposes not listed in this medication guide.

Serious drug interactions can occur when certain medicines are used together with Zelapar. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.

Take Zelapar exactly as it was prescribed for you. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended. Do not change your doses or medication schedule without your doctor's advice.

Zelapar disintegrating tablet should be taken once a day before breakfast and without any liquid.

While you are using Zelapar and for 14 days after you stop, you must not eat foods listed in the "What should I avoid while using Zelapar?" section of this leaflet. Eating these foods while you are using Zelapar can raise your blood pressure to dangerous levels.

Foods that you MAY eat include:

• fresh meat, poultry, or fish (including lunch meat, hot dogs, breakfast sausage, and cooked sliced ham);

• any vegetables except broad bean pods (fava beans);

• processed cheese, mozzarella, ricotta, cottage cheese;

• pizza made with cheeses low in tyramine;

• soy milk, yogurt; or

• Brewer's or baker's yeast.

To take Zelaparorally disintegrating tablets:p>

• Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.

• Using dry hands, remove the tablet and place it on your tongue. It will begin to dissolve right away. Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. Swallow several times as the tablet dissolves.

• Do not drink or eat anything for at least 5 minutes after taking a Zelapar orally disintegrating tablet.

Do not stop taking Zelapar suddenly or you may have harmful side effects. For best results, keep taking the medicine as prescribed.

Store this medicine at room temperature away from moisture and heat.

Keep each Zelapar tablet in the foil blister pack until you are ready to take it. Throw away any tablets not used within 3 months after you have opened the pouch containing the blister pack.

You should not use Zelapar if you are allergic to selegiline, or if you have taken fluoxetine (Prozac, Sarafem and others) within the past 5 weeks.

Some medicines can cause unwanted or dangerous effects when used with Zelapar. Your doctor may need to change your treatment plan if you use any of the following drugs:

• cough medicine that contains dextromethorphan;

• cyclobenzaprine (Flexeril);

• meperidine (Demerol) or other narcotic (opioid) pain medicine;

• methadone;

• St. John's wort;

• tramadol (Ultram, Ultracet);

• an antidepressant - citalopram, desvenlafaxine, duloxetine, escitalopram, fluvoxamine, levomilnacipran, milnacipran, mirtazapine, nefazodone, paroxetine, venlafaxine, vilazodone, vortioxetine, and others; or

• an MAO inhibitor - isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

After you stop taking Zelapar, you must wait at least 14 days before taking any of the medications listed above.

To make sure Zelapar is safe for you, tell your doctor if you have:

• liver or kidney disease;

• high blood pressure; or

• phenylketonuria (Zelapar orally disintegrating tablets may contain phenylalanine).

People with Parkinson's disease may have a higher risk of skin cancer (melanoma). Talk to your doctor about this risk and what skin symptoms to watch for.

It is not known whether Zelapar will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether selegiline passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe headache, hallucinations, vision problems, sweating, cool or clammy skin, fast or uneven heart rate, feeling light-headed, fainting, or seizure (convulsions).

Avoid drinking alcohol while you are taking Zelapar.

While taking Zelapar and for 14 days after you stop, you must NOT eat foods that are high in tyramine, including:

• air dried meats, aged or fermented meats, sausage or salami (including cacciatore and mortadella), pickled herring;

• any spoiled or improperly stored beef, poultry, fish, or liver;

• beer from a tap, beer that has not been pasteurized;

• aged cheeses (such as blue, Swiss, cheddar, Parmesan, or Romano cheese);

• over-the-counter supplements or cough and cold medicines that contain tyramine;

• sauerkraut, soy beans, soy sauce, tofu, fava beans; or

• yeast extracts (such as Marmite).

Eating tyramine while you are using selegiline can raise your blood pressure to dangerous levels which could cause life-threatening side effects. You should become very familiar with the list of foods to avoid while you are using selegiline.

Zelapar may impair your thinking or reactions. Some people taking this medicine have fallen asleep during normal daytime activities such as working, talking, eating, or driving. You may fall asleep suddenly, even after feeling alert. Be careful if you drive or do anything that requires you to be alert.

Get emergency medical help if you have signs of an allergic reaction to Zelapar: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• trouble breathing;

• confusion, hallucinations, unusual thoughts or behavior;

• increased tremors or uncontrolled muscle movements;

• worsening side effects of your other medications;

• high levels of serotonin in the body (when taken with an antidepressant) - agitation, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting; or

• dangerously high blood pressure - severe headache, blurred vision, pounding in your neck or ears, anxiety, nausea, vomiting, severe chest pain, shortness of breath, pounding heartbeats, or seizure (convulsions).

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking this medicine. Talk with your doctor if this occurs.

Common Zelapar side effects may include:

• dizziness;

• nausea, stomach pain, constipation;

• skin rash or other irritation;

• sleep problems (insomnia); or

• mouth sores or ulcers, pain with swallowing (while using Zelapar orally disintegrating tablets).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Many drugs can interact with selegiline, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Zelapar. Give a list of all your medicines to any healthcare provider who treats you.