英文药名: Eldepryl(Selegiline Tablets)

中文药名: 司来吉兰片,咪多吡,帕定平

药品名称

【药物别名】丙炔苯并胺，克金平，思吉宁，盐酸司来吉兰，咪多吡, 帕定平
【外文名】Eldepryl，L-Deprenyl, Selegiline Hydrochloride
药理毒理

盐酸司来吉兰片(思吉宁)是选择性单胺氧化酶-B抑制剂，抑制多巴胺的再摄取及突触前受体。促进脑内多巴胺的功能。
适应症

单用治疗早期帕金森病或与左旋多巴或与左旋多巴及外周多巴脱羧酶抑制剂合用。思吉宁-盐酸司来吉兰片与左旋多巴合用特别适用于治疗运动波动例如由于大剂量左旋多巴治疗引起的剂末波动。
用法用量

单独服用适用于治疗早期帕金森病或与左旋多巴或与左旋多巴/外周多巴脱羧酶抑制剂合用。两者开始剂量为早晨5毫克。思吉宁-盐酸司来吉兰片剂量可增至每天10毫克（早晨一次服用或分开2次）。若病人在合用左旋多巴制剂时显示类似左旋多巴的副反应，左旋多巴剂量应减低。
任何疑问，请遵医嘱！
不良反应

单独服用思吉宁-盐酸司来吉兰片耐受性好。有报导服用思吉宁-盐酸司来吉兰片后病人口干，短暂血清转氨酶值上升及睡眠障碍（例如失眠）的发生率比用安慰剂病人增加。由于思吉宁能增加左旋多巴效果，左旋多巴副反应也会增加。加入思吉宁给已服最大耐受剂量左旋多巴患者，可能出现不随意运动、恶心、激越、错乱、幻觉、头痛、位置性低血压及眩晕。排尿困难及皮疹也曾有报导。应监测潜在的副反应。所以，当加入思吉宁治疗时，左旋多巴剂量应降低平均百分之三十。
注意事项

有胃及十二指肠溃疡，不稳定高血压，心律异常，严重心绞痛或精神病患者服用咪多吡需特别注意。若服过大剂量(超过每天30毫克)，会消失一些抑制单胺氧化酶B受体(MAO-B)的选择性，抑制单胺氧化酶A受体(MAO-A)开始显著增加。所以，同时服用大剂量咪多吡及含高酪胺食品可能引发理论上的高血压症危险，曾报告在咪多吡治疗期中有短暂性肝转氨酶增高。
禁忌

对思吉宁-盐酸司来吉兰片中任一组份过敏者禁用。
药物相互作用

思吉宁-盐酸司来吉兰片治疗中与间接的拟交感神经药相互作用所引起的高血压反应要留意。
治疗帕金森病所用的思吉宁-盐酸司来吉兰片剂量与含酪胺食品同时服用未发现有高血压反应。
本品与非选择性单胺氧化酶抑制剂合用可能引起严重低血压。同时与单胺氧化酶A抑制剂吗氯贝胺服用并无耐药问题的报告。但同期服用此类药品（MAOA及MAOB抑制剂）及酪胺类物质（例如含酪胺食品如发酵食品及饮料、芝士、香肠、腌肉类、野味、肝脏、牛肉汤、咸鱼、豆类及豌豆、德国腌菜及酵母制品）会轻度增加高血压反应。但由于本品与吗氯贝胺同时服用文献报导不详，这两种药不能同时服用。
有报告思吉宁与度冷丁有相互作用，由于有些相互作用可致命并且机理未被确定，所以应避免同时服用。思吉宁与氟西汀同时服用有报告产生严重反应，例如共济失调、震颤、高热、高/低血压、惊厥、心悸、流汗、脸红、眩晕及精神变化（激越、错乱、及幻觉）演变至谵妄及昏迷。思吉宁与其他两种5-羟色胺重摄取抑制剂舍曲林及帕罗西汀同时服用也有类似报导，并且相互作用机制并不清楚了解，这些药物与思吉宁应避免同时服用。
由于氟西汀及其代谢产物的半衰期较长，氟西汀停药最少五星期后才可开始服用思吉宁。另思吉宁及其代谢产物半衰期短，思吉宁停药两星期后即可开始服用氟西汀。在健康志愿者中同时服用思吉宁及西酞普兰无任何临床，药效学或药物动力学的相互作用。不过，同时服用思吉宁及所有选择性5-羟色胺重摄取抑制剂如维拉法辛及氟优沙明都要注意。思吉宁及三环类抗抑郁药同用时要小心，曾报告有严重中枢神经症状。
有几例出现高热、震颤及激越的死亡报告。
其他报告同时服用思吉宁及三环类抗抑郁药的副反应有高/低血压、眩晕、出汗增加、震颤、抽搐、行为及精神改变。由于相互作用机理尚未清楚，加进这些药物于正服用思吉宁的病人要谨慎。

规格：5mg*100 片

Eldepryl Description
This medicine is a monoamine oxidase inhibitor (MAOI) used to treat Parkinson's disease

Eldepryl Directions
Follow the directions for using this medicine provided by your doctor. STORE THIS MEDICINE at room temperature in a tightly-closed container, away from heat and light. CONTINUE TO TAKE THIS MEDICINE even if you feel better. Do not miss any doses. IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Eldepryl Cautions
THIS MEDICINE MAY CAUSE dizziness. If dizziness occurs, sit up or stand slowly. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to this medicine. Most people who take this medicine can eat a normal diet. However, IF YOUR DOSE IS MORE THAN 10 mg/day, serious increases in blood pressure may occur when you eat or drink some foods and drinks. Foods or drinks which may cause a reaction include aged cheeses, sour cream, red wines, beer, bologna, pepperoni, salami, summer sausage, pickled herring, liver, meat prepared with tenderizers, canned figs, raisins, bananas, avocados, soy sauce, fava beans, or yeast extracts. Obtain a complete list of foods and drinks from your doctor, pharmacist, or nurse. DO NOT BECOME OVERHEATED in hot weather or during exercise or other activities since heatstroke may occur. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. This includes medicines that contain pseudoephedrine, phenylpropanolamine, or dextromethorphan. Follow all of these cautions for at least 4 weeks after taking the last dose of this medicine. FOR WOMEN: IF YOU PLAN ON BECOMING PREGNANT, discuss with your doctor the benefits and risks of using this medicine during pregnancy. IT IS UNKNOWN IF THIS MEDICINE IS EXCRETED in breast milk. DO NOT BREAST-FEED while taking this medicine.

Eldepryl Side Effects
SIDE EFFECTS, that may go away during treatment, include dizziness or dry mouth. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience a severe headache, fainting, heart palpitations or changes in heart rate, chest pain, nausea, vomiting, confusion, anxiety, or behavior or mood changes. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Eldepryl Active Ingredients
Selegiline