PD drugs interactions

[Farooqji]

Request to list down the known interactions here. Whether found from some source or self experienced. I have found following two from medscape

Contraindicated

Selegiline + Levodopa

selegiline, levodopa by Mechanism

pharmacodynamic synergism. Contraindicated. Risk of acute

hypertensive episode. Concomitant

therapy with selegiline and carbidopa-levodopa may be associated with severeorthostatic hypotension not attributable tocarbidopa-levodopa alone.

Monitor Closely

Cannabidiol + Selegiline

cannabidiol, selegiline by affecting hepaticenzyme CYP2B6 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP2B6 induction andinhibition with the coadministration of

CYP2B6 substrates and cannabidiol, consider reducing dosage adjustment ofCYP2B6 substrates as clinically

appropriate.

[aspergerian13]

Levodopa, amantadine, and methylphenidate. Together they may induce too much vasodilation, especially as levodopa levels are deliberately increased.

[Cagey84]

Surprising, as the primary use of selegiline seems to be as an adjunct to levodopa. For example,

Mayo clinic:

Selegiline is used in combination with levodopa or levodopa and carbidopa combination to treat Parkinson's disease (sometimes called shaking palsy or paralysis agitans). This medicine works to increase and extend the effects of levodopa, and may help to slow the progress of Parkinson's disease.

FDA:

INDICATIONS AND USAGE: ELDEPRYL is indicated as an adjunct in the management of Parkinsonian patients being treated with levodopa/carbidopa who exhibit deterioration in the quality of their response to this therapy. There is no evidence from controlled studies that selegiline has any beneficial effect in the absence of concurrent levodopa therapy.

I guess the message should be not to change anything without talking to the neurologist.

[Johnmo]

How about rasagiline levodopa and cialis

[Ruffinglgo in reply to Johnmo]

I started on Eliquis and cardiologist and afib nurse don't have a clear understanding of PD meds!!! I asked if they had worked with PD patients. Oh yes. 3! I HAD A REALLY BAD TIME AFTER taking Rasagiline and Lexapro and Eliquis Both when combined with certain blood thinners like Eliquis can cause Bleeds!!!! Does Eliquis have antidote yet? Afib pharmacist said there is "something". Sounds like a fib to me.