Drug interactions
Levodopa + Selegiline
Severity: Moderate
Levodopa and Selegiline: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Selegiline is routinely used with levodopa in Parkinson disease at low doses, where it is selective for MAO-B. At higher doses, selectivity is lost and nonselective MAO inhibition with levodopa can cause hypertensive reactions, while orthostatic hypotension and dyskinesia may also increase. The legacy contraindication overstates the risk at standard oral doses.
What this interaction means in plain words
Levodopa and Selegiline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Levodopa belongs to Central Nervous System; Selegiline belongs to Central Nervous System.
Why it happens
MAO-B inhibition reduces dopamine breakdown and enhances levodopa effect, and loss of selectivity at higher doses permits pressor catecholamine accumulation.
What to do
Keep selegiline at recommended doses and monitor blood pressure, orthostatic symptoms and dyskinesia. Reduce the levodopa dose if dopaminergic adverse effects emerge.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Levodopa and Selegiline, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Selegiline
- Amitriptyline + Selegiline Contraindicated
- Amoxapine + Selegiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
- Benzphetamine + Selegiline Contraindicated
- Brimonidine + Selegiline Contraindicated
- Buprenorphine long-acting + Selegiline Contraindicated
Other interactions of Levodopa
- Isocarboxazid + Levodopa Contraindicated
- Levodopa + Phenelzine Contraindicated
- Levodopa + Phenelzine (nonselective MAOI) Contraindicated
- Levodopa + Procarbazine Contraindicated
- Levodopa + Tranylcypromine Contraindicated
- Amisulpride + Levodopa Major
Frequently asked questions
Can I take Levodopa with Selegiline?
MediHelp rates the interaction as moderate. Levodopa and Selegiline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Selegiline is routinely used with levodopa in Parkinson disease at low doses, where it is selective for MAO-B. At higher doses, selectivity is lost and nonselective MAO inhibition with levodopa can cause hypertensive reactions, while orthostatic hypotension and dyskinesia may also increase. The legacy contraindication overstates the risk at standard oral doses.
How serious is the interaction between Levodopa and Selegiline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Keep selegiline at recommended doses and monitor blood pressure, orthostatic symptoms and dyskinesia. Reduce the levodopa dose if dopaminergic adverse effects emerge.
What other medicines interact with Selegiline?
MediHelp also lists interactions of Selegiline with, for example, Amitriptyline, Amoxapine, Atomoxetine. The full list is on the Selegiline page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
