New Parkinson Medication Approved by the FDA

The FDA recently approved a new Parkinson medication for use in patients that are having problems with off time and freezing. The new drug is called Zelapar. It is a rapidly dissolving tablet whose active ingredient is selegeline. Many of you may have tried selegiline in the past (marketed as Eldepryl.) The new formulation of selegiline allows the drug to be absorbed into the bloodstream through the mouth instead of the stomach. This has the advantage that the medication bypasses going through the liver. All medications absorbed through the stomach and intestines pass through the liver first, which results in clearing much of the medication before it has time to provide benefit. Zelapar allows the selegiline to “go around” the liver so that patients will experience a better therapeutic response to the medication. I have used this on a number of patients who had problems with freezing, increasing off time or just need for higher doses of Sinemet. The added benefit of Zelapar is that it avoids having to increase the total daily Sinemet dosing. More than 50% of the patients have had benefit. Like all medications, Zelapar does not work for everyone and like other anti-Parkinson medications, it has the potential for side effects. It is important that patients with Parkinson’s disease or other movement disorders to be treated by neurologists that have more specialized training in these complex conditions.