Posted by chdurie2 on October 28, 2000, at 17:51:35
In reply to Re: Selegeline Patch - Update? » Deborah14, posted by chdurie2 on October 28, 2000, at 17:20:54
> > Caroline
> > I'm confused. Are you taking the selegeline in a patch/and or gel combo made by one of these compounding pharmacists, or orally by mouth?
> >
> > I already take the 30 mgs of selegeline by mouth but I need to increase it to 50. However, at 50 mgs the side effects are intolerable. My pdoc wants to try the patch because of its supposedly greater efficacy at 30 mgs with less side effects. He explained that medication released transdermal is not metabolized by the liver to the extent that pills are.
> >
> > Please elaborate further on the differences between the generics and Eldypryl made by Somerset Pharmaceuticals? I was switched by my insurance co. from Eldypryl to a generic that is a white pill. I have no idea who manufactures it. I actually voiced this concern to my pdoc yesterday.
> >
> > I too ended up in the ER after increasing my dose of Parnate, per my former pdocs instructions, from one to two pills. (We are no longer on speaking terms.) I too have low blood pressure and there was no food interaction. They thought I burst a blood vessel in my brain. I experienced the most sudden onset of head pain and dizziness in my entire life, as well as chest pains and sweating. It was the worst pain I have ever had beside a collapsed lung. I thought I was going to die. It is believed that my blood pressure spiked from the Parnate even at that low dose. It goes without saying that was the last time I ever went near Parnate.
>
> Deborah-
>
> I take Eldepryl in pills (30 mgs.) But the way I got there was in the context of dicussing a gel to be mixed with piracetam/hydergine, which is what Dean & Morganthaler recommend for cognitive enhancement. I had the gel made without the selegeline becuz my p-doc was concerned about my Parnate reaction. But Mike Webber at Family Pharmacy offered to make a selegeline gel by itself or one that would combine the three (by prescription, of course.) His point was that the selegeline gave the mix a powerful punch. The reason to use a gel with piracetam is that you have to take huge quantities for it to be effective, and it is unbelievably nauseating, not to mention tedious to take so many pills.
>
> So it was in this whole exploration that my p-doc said no to the selegeline gel, because he wanted more control over dosage than he thought the gel would give, and he didn't see a good reason from a side effects point of view why the gel would be superior. so i ran selegeline on medline, and came up with this seemingly good study that said it made no difference - i believe they matched equal amounts of selegeline in both pill and gel study groups.
>
> so i don't know if the liver is a problem at 50 mgs. i know that 40 mgs is the normal dosage for those who have parkinson's and need help with depression.
>
> what kind of side effects do you have at 50 mgs? i'm interested cuz i may ask my p-doc to raise the dosage. But when i felt that 30 mgs was no longer doing the job, eldepryl or generic, i asked for something else to augment it rather than suggesting an increased dosage. I'm now on wellbutrin, 300 mgs daily, and i think that's doing okay. my last try with wellbutrin alone, which was my second wellbutrin try, was a bust.
> so it may be that eldepryl and wellbutrin work well together, i don't know. the other possible candidate for augmentation was prozac, which i've done several times before with mixed results, but my p-doc picked wellbutrin becuz of its "activating" aspect.
>
> the little round white pill you mention, if it's the same one i had, is the reason i then insisted on eldepryl. the first selegeline i got was a light blue and navy capsule, and that was great. then i got the little white round pill, and i immediately noticed it was less effective. i asked my pharmacist if she could get me the light blue and navy capsule again, and she said she's at the mercy of whatever the wholesaler/distributor gives her as a generic-so she couldn't be sure what she got with each order.that's when i suggested to my p-doc that we go with eldepryl, cuz brand names are generally better and more even in quality. he concurred. the eldepryl pills are solid light blue capsules. i mentioned this difference to the part-time pharmacist, and he said he thought the light blue and navy capsules were in fact eldepryl sold under a generic name; he said brand name manufacturers sometimes make and sell generics, but really it's all the same if it comes from them-it's just a way for them to sell more eldepryl, he said, cuz they know many hmo's etc won't authorize brand name if a generic is available.
>
> so that's what i know about eldepryl/selegeline. obviously, your p-doc and mine differ on whether a gel would be more effective.
>
> mike webber at family pharmacy is very good but he's on the expensive side. wellness and college are similar and cheaper; i prefer wellness cuz college has a habit of screwing up my order - they send free duplicates, but it's a hassle. i have used all to compound liquid injectables.
>
> i know what you mean about parnate. if i didn't say so before, my p-doc now says my minor dietary transgression had nothing to do with what happened - the transgression wasn't serious enuf to bring on a near-fatal reaction. (i drank a chocolate milk shake without thinking, and wound up almost having a stroke. went by ambulance to the emergency room, and they were already administering the antidote via iv in the ambulance-then at hospital they immediately induced vomiting and diarrhea. said i made it in the nick of time. at one point i remember nurses outside my room whispering whether i was gonna make it or not- i was in a "coma" and i just told myself that i had to make it.) that was my first and only day of parnate.
>
> CarolineDeborah- since i see you have questions on compounding, a compounding pharmacist is one who is licensed to make up things "from scratch" according to a formula. some compounders can only do pills, and some can do both pills and liquid, either oral or injectable. it has to do with how sophisticated their facility is - you need a separate room for liquids, i think.
if i were getting a selegeline gel, i would want to make sure that the compounder had made one before. although many have access to the same formulas, my NJ guy thought he was doing me a favor and put butene alcohol in one of my injectables without my authorization to help aleviate the pain of the stuff. problem was, my inquiries turned up the fact that the major ingredient in the thing is not stable enuf to withstand butene alcohol; that's why experienced guys don't do it. and he knew the stuff wasn't all that stable, but this was the first time he had made it. when i confronted him, he was not nice about it and refused my request to a "makegood." so although they all say they can read a formula and make stuff, i wouldn't buy it from anyone who hadn't made it before.
i probably would go with mike webber at family for a selegeline gel, cuz i know he's made it before. i would, i think, however, trust steve at wellness, cuz i know any time there has been the slightest question about anything he has checked with either me or my doctor, and he refused to make the piracetam gel for me because he was uncertain about how to do it, never having made it before. that's a lot of integrity. i might also try college, but they'd be a third choice - they're too big, in my opinion, to trust with a selegeline gel unless they've made it a lot before, which they may have. all three of these have 800 numbers. if you call, you can use the regular number and just ask for the 800 numbers and call them right back on those.
you certainly don't have to use these people, but because i've ordered from them a bunch of times, i know them.
let me know how it works out. if you have a better experience with the gel, maybe i'll do it too and talk my p-doc into it now that we know there's no problem with a possible hypertensive incident.
also, again, what are your side effects on 50 mgs? and is 50 mgs really more effective than 30?
caroline
poster:chdurie2
thread:46818
URL: http://www.dr-bob.org/babble/20001022/msgs/47640.html